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Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database()()

BACKGROUND: The present study characterized the incidence of venous thromboembolism in a contemporary cohort of surgical oncology patients and its association with index hospitalization and postdischarge outcomes. METHODS: Adults undergoing 7 major thoracic and abdominal cancer resections were ident...

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Autores principales: Pan, Chelsea S., Sanaiha, Yas, Hadaya, Joseph, Lee, Cory, Tran, Zachary, Benharash, Peyman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166654/
https://www.ncbi.nlm.nih.gov/pubmed/35669894
http://dx.doi.org/10.1016/j.sopen.2022.04.005
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author Pan, Chelsea S.
Sanaiha, Yas
Hadaya, Joseph
Lee, Cory
Tran, Zachary
Benharash, Peyman
author_facet Pan, Chelsea S.
Sanaiha, Yas
Hadaya, Joseph
Lee, Cory
Tran, Zachary
Benharash, Peyman
author_sort Pan, Chelsea S.
collection PubMed
description BACKGROUND: The present study characterized the incidence of venous thromboembolism in a contemporary cohort of surgical oncology patients and its association with index hospitalization and postdischarge outcomes. METHODS: Adults undergoing 7 major thoracic and abdominal cancer resections were identified in the 2016–2019 Nationwide Readmissions Database. Multivariable models stratified by operative subtype were developed to evaluate the association of venous thromboembolism with outcomes of interest. RESULTS: Of an estimated 436,368 patients, venous thromboembolism was identified in 9,811 (2.2%) patients during index hospitalization. Esophageal (4.1%) and gastric (4.1%) resections exhibited the highest rates of venous thromboembolism, whereas pulmonary resection (1.0%) the lowest. Following adjustment, cancer resection type demonstrated the strongest association with venous thromboembolism development among all factors analyzed (adjusted odds ratio: 3.13, 95% confidence interval: 2.60–3.78). Diagnosis of venous thromboembolism was associated with increased mortality (10.2%, 95% confidence interval: 9.4–11.1 vs 1.7, 95% confidence interval: 1.6–1.7) and prolonged index hospital stay (19.5 days, 95% confidence interval: 19.1–20.0 vs 7.5, 95% confidence interval: 7.4–7.5). Of patients who survived index hospitalization, venous thromboembolism occurrence was associated with increased risk of nonhome discharge (56.4%, 95% confidence interval: 54.7–58.0 vs 14.4, 95% confidence interval: 14.2–14.7) and readmission (30.0%, 95% confidence interval: 28.5–31.1 vs 16.9, 95% confidence interval: 16.7–17.1). Additionally, venous thromboembolism substantially increased index hospitalization ($40,000, 95% confidence interval: $38,000–$42,000) and readmission costs ($3,200, 95% confidence interval: $1,700–$4,700). CONCLUSION: Rates of venous thromboembolism remain high in surgical oncology patients, with cancer resection type as a major predictor of venous thromboembolism incidence. Venous thromboembolism was associated with inferior clinical and financial outcomes that extended beyond discharge. These findings underscore the importance of continued vigilance and procedure-specific prophylaxis measures.
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spelling pubmed-91666542022-06-05 Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database()() Pan, Chelsea S. Sanaiha, Yas Hadaya, Joseph Lee, Cory Tran, Zachary Benharash, Peyman Surg Open Sci Original Article BACKGROUND: The present study characterized the incidence of venous thromboembolism in a contemporary cohort of surgical oncology patients and its association with index hospitalization and postdischarge outcomes. METHODS: Adults undergoing 7 major thoracic and abdominal cancer resections were identified in the 2016–2019 Nationwide Readmissions Database. Multivariable models stratified by operative subtype were developed to evaluate the association of venous thromboembolism with outcomes of interest. RESULTS: Of an estimated 436,368 patients, venous thromboembolism was identified in 9,811 (2.2%) patients during index hospitalization. Esophageal (4.1%) and gastric (4.1%) resections exhibited the highest rates of venous thromboembolism, whereas pulmonary resection (1.0%) the lowest. Following adjustment, cancer resection type demonstrated the strongest association with venous thromboembolism development among all factors analyzed (adjusted odds ratio: 3.13, 95% confidence interval: 2.60–3.78). Diagnosis of venous thromboembolism was associated with increased mortality (10.2%, 95% confidence interval: 9.4–11.1 vs 1.7, 95% confidence interval: 1.6–1.7) and prolonged index hospital stay (19.5 days, 95% confidence interval: 19.1–20.0 vs 7.5, 95% confidence interval: 7.4–7.5). Of patients who survived index hospitalization, venous thromboembolism occurrence was associated with increased risk of nonhome discharge (56.4%, 95% confidence interval: 54.7–58.0 vs 14.4, 95% confidence interval: 14.2–14.7) and readmission (30.0%, 95% confidence interval: 28.5–31.1 vs 16.9, 95% confidence interval: 16.7–17.1). Additionally, venous thromboembolism substantially increased index hospitalization ($40,000, 95% confidence interval: $38,000–$42,000) and readmission costs ($3,200, 95% confidence interval: $1,700–$4,700). CONCLUSION: Rates of venous thromboembolism remain high in surgical oncology patients, with cancer resection type as a major predictor of venous thromboembolism incidence. Venous thromboembolism was associated with inferior clinical and financial outcomes that extended beyond discharge. These findings underscore the importance of continued vigilance and procedure-specific prophylaxis measures. Elsevier 2022-05-07 /pmc/articles/PMC9166654/ /pubmed/35669894 http://dx.doi.org/10.1016/j.sopen.2022.04.005 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Article
Pan, Chelsea S.
Sanaiha, Yas
Hadaya, Joseph
Lee, Cory
Tran, Zachary
Benharash, Peyman
Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database()()
title Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database()()
title_full Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database()()
title_fullStr Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database()()
title_full_unstemmed Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database()()
title_short Venous thromboembolism in cancer surgery: A report from the nationwide readmissions database()()
title_sort venous thromboembolism in cancer surgery: a report from the nationwide readmissions database()()
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166654/
https://www.ncbi.nlm.nih.gov/pubmed/35669894
http://dx.doi.org/10.1016/j.sopen.2022.04.005
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