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Patients undergoing outpatient surgery also at risk for VTE events, study finds

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A recently published study by researchers in the University of Michigan Health System has revealed a need for better patient screening of patients who undergo outpatient surgery.

“These data are in stark contrast to provider and patient expectations that outpatient surgery is a low-risk event,” lead study author Christoper J. Pannuci, MD, stated in a University of Michigan Health System release. “It also underscores the importance of evaluating a patient’s individual risk factors as opposed to procedure type alone.”

The findings were published in the Annals of Surgery.

Pannucci and his team performed an observational cohort study of patients within the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2009. According to the study abstract, patients included in the study were adults who underwent outpatient surgery or surgery with subsequent 23-hour observation, with the main outcome measure being 30-day venous thromboembolism (VTE) that required treatment.

Researchers randomly assigned patients to one of two groups, according to the study abstract, with 173,501 patients going into a derivation cohort and 85,730 patients going into a validation cohort. The researchers then used logistic regression to examine the independent risk factors for 30-day VTE.

According to the study results, overall the cohort displayed a 30-day VTE incidence rate of 0.15%. Pregnancy, active cancer, age of 41 years or more, operative time of more than 2 hours, arthroscopic surgery and high BMI were all found to be independent risk factors, with weighted risk analysis revealing a 20-fold variation in 30-day VTE between low risk (0.06%) and highest risk (1.18%) patients.

The information has allowed the researchers to create and validate a risk-stratification tool that can be used to predict a patient’s risk for VTE, the release noted. This risk model, the researchers stated, may improve the informed consent process for those undergoing outpatient surgery by providing clear, data-driven information about a patient’s risk for developing VTE.

Reference:

• Pannucci CJ, Shanks A, Moote MJ, et al. Identifying patients at high risk for venous thromboembolism requiring treatment after outpatient surgery. Ann Surg. 2012. doi: 10.1097/SLA.0b013e3182519ccf