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Rates of Venous Thromboembolism Among Patients with Major Surgery for Cancer

  • Healthcare Policy and Outcomes
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Previous studies have reported VTE rates during surgical stays in hospitals or by diagnoses over extended periods without being linked to specific surgical events. The purpose of this project was to assess the potential rate of venous thromboembolism in patients with cancer after a surgical procedure within the immediate posthospital admission period of 30 days, with special emphasis in increased sensitivity of detection.

Methods

Patients with cancer who had a major surgery were identified in a large commercial (non-Medicare) database containing data from more than 22 million patients in the United States. Those with a new diagnosis of VTE within 30 days postadmission for surgery were identified. Additional drug-based criteria were used to vary the VTE definition in a sensitivity analysis. VTE rates are reported for each of the surgical procedure group and overall.

Results

The overall 30-day VTE rate was 3.5% with a diagnosis based definition, with rates ranging by procedure from 1.8 to 13.2%. Esophageal resection patients have a VTE rate of 13.2% (95% confidence interval (CI), 8.8–18.9%), whereas prostatectomy patients have a VTE rate of 1.8% (95% CI, 1.5–2.1%). Of the 3.5% of patients with a VTE diagnosis on or before postoperative day 30, 73% of those have the VTE diagnosis by day 14. Another 1.15% is added to the overall VTE rate as the definition sensitivity is increased with outpatient pharmacy claims data.

Conclusions

Using administrative data from large populations provides valuable insight into the potential VTE rates that occur within the 30-day post period after various cancer-related surgeries. The information can be used by surgeons as one component of the benefit-risk decision regarding postoperative VTE prophylaxis in surgical patients.

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Authors and Affiliations

  1. Ethicon Biosurgery, Ethicon, Inc, Somerville, NJ, USA

    Jeffrey Hammond MD, MPH

  2. CK Consulting, Steamboat Springs, CO, USA

    Chris Kozma PhD

  3. Ethicon, Inc, Somerville, NJ, USA

    James C. Hart MD

  4. Johnson & Johnson, New Brunswick, NJ, USA

    Somesh Nigam PhD & Mehmet Daskiran PhD

  5. Vigilytics, Victor, NY, USA

    Andrew Paris MBA

  6. Center for Outcomes Research, Nashville, TN, USA

    John I. Mackowiak PhD

Authors
  1. Jeffrey Hammond MD, MPH
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  2. Chris Kozma PhD
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  3. James C. Hart MD
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  4. Somesh Nigam PhD
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  5. Mehmet Daskiran PhD
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  6. Andrew Paris MBA
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  7. John I. Mackowiak PhD
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Corresponding author

Correspondence to Jeffrey Hammond MD, MPH.

Additional information

Funding was provided by Ethicon.

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Hammond, J., Kozma, C., Hart, J.C. et al. Rates of Venous Thromboembolism Among Patients with Major Surgery for Cancer. Ann Surg Oncol 18, 3240–3247 (2011). https://doi.org/10.1245/s10434-011-1723-2

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  • DOI: https://doi.org/10.1245/s10434-011-1723-2

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