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Venous thromboembolism and transfusion after major abdominopelvic surgery

Published:March 02, 2020DOI:https://doi.org/10.1016/j.surg.2019.12.016
      This was a very large study involving nearly 900,000 patients that was done to evaluate venous thromboembolism (VTE) risk as well as the risk of transfusion after major abdominopelvic surgical procedures. The authors also analyzed the association of the surgical procedure with the incidence of VTE. A further goal was to evaluate their definition of the Caprini score and see if it improves the association of their model with VTE. The primary outcome was VTE incidence within 30 days of surgery, and the secondary outcome was the incidence of blood transfusion within 30 days postoperatively. An additional major aim was to evaluate the incidence of VTE according to operative time. The authors queried the National Surgical Quality Improvement Program (NSQIP) database from the American College of Surgeons. The authors found that the highest risk of VTE occurred in patients undergoing either partial or total esophagectomy. The authors found an independent association between the length of the procedure and the risk of VTE. These findings occurred without any association with their definition of Caprini score. Pelvic exoneration and radical cystectomy were found to have the highest risk of blood transfusion. The authors suggested that improved risk stratification could be achieved by adding more procedural information into the scoring system.
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      Reference

        • Pannucci C.J.
        • Swistun L.
        • MacDonald J.K.
        • Henke P.K.
        • Brooke B.S.
        Individualized venous thromboembolism risk stratification using the 2005 Caprini score to identify the benefits and harms of chemoprophylaxis in surgical patients: a meta-analysis.
        Ann Surg. 2017; 265: 1094-1103

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