Abstract：
BACKGROUND:Patients undergoing emergency general surgery (EGS) operations experience high rates of venous thromboembolism (VTE). The rates at which thrombus formation occurs after discharge, and whether VTE prophylaxis at discharge might be warranted to prevent readmission, are unknown. This analysis aimed to determine risk factors associated with VTE formation after discharge for EGS operations. STUDY DESIGN:An analysis of the American College of Surgeons NSQIP database from 2013 and 2014 of patients undergoing 10 common EGS operations in an emergent fashion. Multivariable logistic regression modeling was used to determine factors that predicted VTE after discharge. RESULTS:A total of 130,036 patients were included. The 30-day VTE rate was 1.30%, with 35% of all VTEs occurring after discharge. Of those who had VTE develop after discharge, 69.4% required readmission. Predictive factors for post-discharge VTE included prolonged length of stay (odds ratio [OR] 5.25; p < 0.001), presence of metastatic cancer (OR 2.23; p < 0.001), urinary tract infection (OR 1.91; p < 0.001), and postoperative sepsis (OR 1.55; p < 0.001). Identified high-risk groups had a rate of readmission with thrombus 6 times greater than that of average-risk EGS patients. CONCLUSIONS:More than 30% of VTEs in the EGS population occur after discharge; of these, a vast majority require readmission. Select high-risk EGS subgroups might benefit from prophylactic anticoagulation at discharge.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
DeWane MP,Davis KA,Schuster KM,Maung AA,Becher RDdoi
10.1016/j.jamcollsurg.2018.03.021subject
Has Abstractpub_date
2018-06-01 00:00:00pages
1072-1077.e3issue
6eissn
1072-7515issn
1879-1190pii
S1072-7515(18)30215-1journal_volume
226pub_type
杂志文章abstract：BACKGROUND:The choice between breast-conserving surgery and modified radical mastectomy in the treatment of women with early stage breast cancer in the Department of Defense Healthcare System may be influenced by demographic factors. STUDY DESIGN:The Department of Defense Automated Central Tumor Registry (ACTUR) was q...
journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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更新日期：1996-12-01 00:00:00
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journal_title：Journal of the American College of Surgeons
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更新日期：1994-06-01 00:00:00
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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journal_title：Journal of the American College of Surgeons
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更新日期：1995-09-01 00:00:00
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更新日期：1997-03-01 00:00:00
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