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Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models
BACKGROUND: Venous thromboembolism (VTE) risk models including the Davison risk score and the 2005 Caprini risk assessment model have been validated in plastic surgery patients. However, their utility and predictive value in breast reconstruction has not been well described. We sought to determine t...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457260/ https://www.ncbi.nlm.nih.gov/pubmed/26090287 http://dx.doi.org/10.1097/GOX.0000000000000372 |
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author | Subichin, Michael P. Patel, Niyant V. Wagner, Douglas S. |
author_facet | Subichin, Michael P. Patel, Niyant V. Wagner, Douglas S. |
author_sort | Subichin, Michael P. |
collection | PubMed |
description | BACKGROUND: Venous thromboembolism (VTE) risk models including the Davison risk score and the 2005 Caprini risk assessment model have been validated in plastic surgery patients. However, their utility and predictive value in breast reconstruction has not been well described. We sought to determine the utility of current VTE risk models in this population and the VTE rate observed in various methods of breast reconstruction. METHODS: A retrospective review of breast reconstructions by a single surgeon was performed. One hundred consecutive transverse rectus abdominis myocutaneous (TRAM) patients, 100 consecutive implant patients, and 100 consecutive latissimus dorsi patients were identified over a 10-year period. Patient demographics and presence of symptomatic VTE were collected. 2005 Caprini risk scores and Davison risk scores were calculated for each patient. RESULTS: The TRAM reconstruction group was found to have a higher VTE rate (6%) than the implant (0%) and latissimus (0%) reconstruction groups (P < 0.01). Mean Davison risk scores and 2005 Caprini scores were similar across all reconstruction groups (P > 0.1). The vast majority of patients were stratified as high risk (87.3%) by the VTE risk models. However, only TRAM reconstruction patients demonstrated significant VTE risk. CONCLUSIONS: TRAM reconstruction appears to have a significantly higher risk of VTE than both implant and latissimus reconstruction. Current risk models do not effectively stratify breast reconstruction patients at risk for VTE. The method of breast reconstruction appears to have a significant role in patients’ VTE risk. |
format | Online Article Text |
id | pubmed-4457260 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-44572602015-06-18 Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models Subichin, Michael P. Patel, Niyant V. Wagner, Douglas S. Plast Reconstr Surg Glob Open Original Article BACKGROUND: Venous thromboembolism (VTE) risk models including the Davison risk score and the 2005 Caprini risk assessment model have been validated in plastic surgery patients. However, their utility and predictive value in breast reconstruction has not been well described. We sought to determine the utility of current VTE risk models in this population and the VTE rate observed in various methods of breast reconstruction. METHODS: A retrospective review of breast reconstructions by a single surgeon was performed. One hundred consecutive transverse rectus abdominis myocutaneous (TRAM) patients, 100 consecutive implant patients, and 100 consecutive latissimus dorsi patients were identified over a 10-year period. Patient demographics and presence of symptomatic VTE were collected. 2005 Caprini risk scores and Davison risk scores were calculated for each patient. RESULTS: The TRAM reconstruction group was found to have a higher VTE rate (6%) than the implant (0%) and latissimus (0%) reconstruction groups (P < 0.01). Mean Davison risk scores and 2005 Caprini scores were similar across all reconstruction groups (P > 0.1). The vast majority of patients were stratified as high risk (87.3%) by the VTE risk models. However, only TRAM reconstruction patients demonstrated significant VTE risk. CONCLUSIONS: TRAM reconstruction appears to have a significantly higher risk of VTE than both implant and latissimus reconstruction. Current risk models do not effectively stratify breast reconstruction patients at risk for VTE. The method of breast reconstruction appears to have a significant role in patients’ VTE risk. Wolters Kluwer Health 2015-06-05 /pmc/articles/PMC4457260/ /pubmed/26090287 http://dx.doi.org/10.1097/GOX.0000000000000372 Text en Copyright © 2015 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. |
spellingShingle | Original Article Subichin, Michael P. Patel, Niyant V. Wagner, Douglas S. Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models |
title | Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models |
title_full | Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models |
title_fullStr | Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models |
title_full_unstemmed | Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models |
title_short | Method of Breast Reconstruction Determines Venous Thromboembolism Risk Better Than Current Prediction Models |
title_sort | method of breast reconstruction determines venous thromboembolism risk better than current prediction models |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457260/ https://www.ncbi.nlm.nih.gov/pubmed/26090287 http://dx.doi.org/10.1097/GOX.0000000000000372 |
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