Issue: July 10, 2015
June 15, 2015
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Post-pneumonectomy VTE screening presents path to reduce risks

Issue: July 10, 2015
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Screening for venous thromboembolism after lung cancer surgery improves detection and presents an opportunity to potentially minimize related risks for complications or death through anticoagulation therapy or repeat screening, researchers at the Cleveland Clinic found.

Venous thromboembolism (VTE) rates following lung removal were higher among patients screened during their hospital stay, and the risk was elevated up to a month post-procedure, than patients not screened, according to results released at the American Association for Thoracic Surgery annual meeting.

Siva Raja, MD, PhD, of the Heart and Vascular Institute, department of thoracic and cardiovascular surgery, Cleveland Clinic, and colleagues compared VTE rates of inpatients who underwent pneumonectomy for both benign and malignant indications and screening (n = 112) against a previous group of similar patients without screening (n = 336).

Siva Raja

Siva Raja

In-hospital VTEs were detected nearly three times more frequently in the screened group compared with those not screened (8.9% vs. 3%), according to the release. Similar results were observed in the 30-day postoperative period (13% vs. 5%, respectively).

In the screened group, VTEs were detected in 10 patients prior to discharge; four additional patients developed symptomatic VTE within 30 days despite a negative screen prior to leaving the hospital.

The Cleveland Clinic has been conducting routine VTE screening on patients following pneumonectomy prior to discharge since 2006, according to the release. VTE risk peaks 6 days after surgery, which corresponds to the median length of the hospital stay, according to Raja.

“We find that a large proportion (50%) of VTEs occurred prior to the time of discharge, and the risk of developing symptomatic VTE remained elevated for 30 days,” Raja said in the release. “It is possible that the prevalence of VTE may be even higher should a comprehensive serial screening program be initiated.”

 Reference:

Raja S, et al. Abstract 23. Presented at: The American Association for Thoracic Surgery Annual Meeting; April 25-29; Seattle.

 Disclosure: Raja reports no relevant financial disclosures.