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Inpatient setting, trunk and multiple region contouring increase venous thromboembolism risk

The biggest predictors of venous thromboembolism among patients undergoing body contouring procedures were older age, contouring of the trunk, obesity and admission on an inpatient basis, according to recent data.

With these data, the researchers developed a risk-scoring model to calculate a patient’s distinct risk for venous thromboembolism.

John P. Fischer

Patients who underwent body contouring procedures between 2005 and 2012 were identified using the American College of Surgeons National Surgical Quality of Improvement Program databases. Researchers utilized the procedural coding for surgical contouring of the thigh, leg, hip, buttocks, arm and abdomen, as well as mastopexy, mammoplasty and suction-assisted lipectomy.

Venous thromboembolism was the primary outcome, which included deep venous thrombosis and pulmonary embolism.

During the study period, 17,774 patients were identified, of which 94.6% were women and were aged 45 to 65 years.

The breast and abdomen were the most popular regions for contouring at 66.8% and 30.9%, respectively.

Approximately two-thirds of the cohort underwent the procedure in an outpatient setting and around the same amount were performed by plastic surgeons.

The average BMI of patients undergoing the procedure was 31.4.

Out of 17, 774 patients, 99 patients (0.56%) developed venous thromboembolism postoperatively: 46 patients experienced deep venous thrombosis, 44 had pulmonary embolism and nine patients experienced both.

Having a BMI greater than 35 was assigned a risk score of 3, or the greatest risk in this series.

Age over 65 years, a BMI of 30 to 34.9, being operated on in an inpatient setting, undergoing trunk contouring and undergoing contouring of more than two regions was assigned a risk score of 2, for a moderate risk.

The lowest risk score of 1 was assigned to those age 45 to 65 years and a nonclean wound class.

Researchers concluded that prolonged outpatient venous thromboembolism prophylaxis for high-risk patients may be a risk-reducing intervention. – by Abigail Sutton

Disclosure: The authors reported no relevant financial disclosures.