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Elevated PE risk seen beyond 6 weeks after various types of surgery
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Regardless of the surgery type, the risk of postoperative pulmonary embolism was elevated at more than 6 weeks postoperatively, according to published results.
Using a French national inpatient database, researchers performed a case-crossover analysis of 60,703 cancer-free middle-aged patients with a diagnosis of a first pulmonary embolism (PE) who underwent either hip or knee replacement (n=989), fracture surgery (n=1,146), other orthopedic procedures (n=1,944), vascular surgery (n=1,002), gynecological surgery (n=522) or gastrointestinal surgery (n=2,061). Diagnosis of a first PE was the primary outcome.
Results showed that after all types of surgery, the risk of postoperative PE was elevated for a minimum of 12 weeks. The risk of PE for all surgery types was highest during the immediate postoperative period from 1 week to 6 weeks.
“The excess risk of postoperative pulmonary embolism ranged from odds ratio (OR), 5.24 (95% CI, 3.91-7.01) for vascular surgery to OR, 8.34 (95% CI, 6.07-11.45) for surgery for fractures,” the researchers wrote. From 7 to 12 weeks, the risk remained elevated with an OR of 2.26 for gastrointestinal operations to an OR of 4.23 for surgery for fractures. For all types of surgery, there was no clinically significant risk after 18 weeks postoperatively.
After orthopedic surgeries not linked with fracture surgery, there was a lower risk of late postoperative PE between 7 to 12 weeks postoperatively. Investigators noted the odds ratios after hip or knee replacement and after other orthopedic procedures during this time were 3.64 and 2.82, respectively. – by Monica Jaramillo
Disclosure s : The authors report no relevant financial disclosures.
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