Timing Matters: Postoperative VTE Follows Different Timelines Across Surgical Specialties

Area of Science:

• Surgical Outcomes
• Vascular Surgery
• Public Health

Background:

• Postoperative venous thromboembolism (VTE) incidence and timing are not well-defined across surgical specialties.
• Understanding these patterns is crucial for improving patient care.

Purpose of the Study:

• To evaluate the incidence and temporal pattern of VTE in a national cohort of surgical patients.
• To identify variations in VTE risk and diagnosis timing across different surgical specialties.

Main Methods:

• Analysis of data from the 2022 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP).
• Inclusion of adult patients undergoing common procedures in general, colorectal, vascular, plastic surgery, surgical oncology, and gynecology.
• Assessment of VTE incidence (deep vein thrombosis or pulmonary embolism) and time to diagnosis post-surgery.

Main Results:

• Overall VTE incidence was 0.8% within 30 days, with surgical oncology (3%) and colorectal surgery (2%) having the highest rates.
• Median time to VTE diagnosis was 9 days, with 54% diagnosed after discharge.
• Plastic surgery had the highest post-discharge diagnosis rate (77%), while surgical oncology and colorectal surgery had higher VTE odds but lower post-discharge diagnoses.

Conclusions:

• Postoperative VTE temporal patterns differ significantly across surgical specialties.
• A substantial proportion of VTE events occur post-discharge, indicating a need for extended surveillance.
• Specialty-specific perioperative practices influence VTE risk and timing, requiring tailored prevention and management strategies.