Venous Thromboembolism Following Major Surgery and Risk of Recurrence: A Population-Based Cohort Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5243-5243
Author(s):  
Dimple Kondal ◽  
Susan R. Kahn ◽  
Vicky Tagalakis
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
General Surgery ◽  
Research Funding ◽  
Population Based ◽  
Major Surgery ◽  
Adjusted Relative Risk ◽  
Post Discharge ◽  
Risk Of Recurrence ◽  
The Mean

Abstract Abstract 5243 Background: Venous thromboembolism (VTE) which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) is a common complication of major surgery. Little is known of the risk of recurrent VTE following postoperative VTE. Objectives: We used the administrative health claims (RAMQ) and hospital discharge (MED ECHO) databases of Quebec, Canada to conduct a population-based retrospective cohort study to describe the time to VTE following general surgery and to assess the risk of VTE recurrence among patients with surgery-provoked VTE. Methods: Using a previously defined cohort of individuals who had a first-time discharge diagnosis of VTE between January 1996 and December 2004 in MED ECHO, which systematically records information on all hospital admissions in the province of Quebec, we identified patients who had undergone major surgery in the 3 months prior to the VTE. Subjects were followed from the time of incident VTE until first VTE recurrence, death, or end of study (December 31, 2005). Results: Our study population consisted of 9629 patients with new VTE up to 3 months following major surgery. The mean age was 63.9 years (SD=15.2) and 53% were female. General surgery (32%) was the most common procedure. The mean time to VTE after surgery was 29.5 days (SD=62.6) with 30% of events diagnosed after discharge. The 5-year adjusted cumulative risk of recurrence was 7.9%. Patients with VTE diagnosed after discharge had an adjusted relative risk of recurrence of 1.43 (95% confidence interval (1.21, 1.69)) compared to patients with VTE diagnosed before discharge. Conclusions: Our results suggest that surgery-provoked VTE occurs frequently after discharge and is associated with an elevated risk of recurrence, and that patients with post-discharge VTE are at a higher risk of recurrence than patients with VTE diagnosed before discharge. Thromboprophylaxis strategies post-discharge should be considered in this population. Disclosures: Tagalakis: Sanofi Aventis: Research Funding; Pfizer: Research Funding.

scholarly journals Risk of Post-Discharge Venous Thromboembolism and Associated Mortality in General Surgery: A Population-Based Cohort Study Using Linked Hospital and Primary Care Data in England

PLoS ONE ◽  
2015 ◽  
Vol 10 (12) ◽  
pp. e0145759 ◽  
Author(s):  
George Bouras ◽  
Elaine Marie Burns ◽  
Ann-Marie Howell ◽  
Alex Bottle ◽  
Thanos Athanasiou ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
General Surgery ◽  
Population Based ◽  
Post Discharge ◽  
Primary Care Data

Venous Thromboembolism in Cancer Patients Following Major Surgery

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5253-5253
Author(s):  
Tierry Haim Toledano ◽  
Dimple Kondal ◽  
Susan R. Kahn ◽  
Vicky Tagalakis
Keyword(s):  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Hospital Discharge ◽  
Surgical Procedures ◽  
Cancer Diagnosis ◽  
Research Funding ◽  
Hospital Admissions ◽  
Major Surgery ◽  
The Mean

Abstract Abstract 5253 Background: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is common in cancer patients and surgery is an important risk factor. The timing of post-operative VTE in cancer patients is uncertain. Objectives: We used the administrative health claims (RAMQ) and hospital discharge (MED ECHO) databases of Quebec, Canada to describe the occurrence of post-operative VTE in cancer patients and to explore anticoagulant use following hospital discharge. Methods: Using a previously defined cohort of individuals with a discharge diagnosis of VTE between January 1, 1994 and December 31, 2004 in MED ECHO which systematically records information on all hospital admissions in the province of Quebec, we identified patients with a cancer diagnosis in the 12 months preceding the VTE and who had major surgery in the 3 months prior to the VTE. Discharge diagnoses were defined according to the 9th edition International Classification of Diseases codes and surgical procedures according to the Canadian classification of diagnostic, therapeutic, and surgical procedures. Results: In all, 2706 patients with VTE had a cancer diagnosis and underwent major surgery in the 3 months preceding the VTE. The mean age was 65.9 years (SD=12.6) and 54% were female. The most common cancer was gastrointestinal (38%), and general surgery was the most frequent procedure (48%). The mean hospital stay was 29.8 days (SD=35.3). The mean time to VTE was 34.8 days (SD=68.3). In all, 34% of VTE events occurred after discharge. Among patients with post-discharge VTE (n=917), 4% had an out-patient anticoagulant prescription at discharge. Conclusions: Post-operative VTE in cancer patients often occurs after hospital discharge. This suggests that the risk of VTE extends beyond the immediate postoperative period. Prospective studies are needed to determine the effectiveness and safety of thromboprophylaxis beyond discharge in cancer patients undergoing surgery. Disclosures: Tagalakis: Sanofi Aventis: Research Funding; Pfizer: Research Funding.

Estimated GFR and Incidence of Major Surgery: A Population-Based Cohort Study

2020 ◽  
Author(s):  
Tyrone G. Harrison ◽  
Shannon M. Ruzycki ◽  
Matthew T. James ◽  
Paul E. Ronksley ◽  
Kelly B. Zarnke ◽  
...  
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Major Surgery ◽  
Estimated Gfr

Epidemiology of first and recurrent venous thromboembolism: A population-based cohort study in patients without active cancer

2014 ◽  
Vol 112 (08) ◽  
pp. 255-263 ◽  
Author(s):  
Alexander T. Cohen ◽  
Luke Bamber ◽  
Stephan Rietbrock ◽  
Carlos Martinez
Keyword(s):  
Cohort Study ◽  
Venous Thromboembolism ◽  
The Elderly ◽  
Population Based ◽  
Incidence Rates ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Recurrence Rates ◽  
Recurrent Vte ◽  
Active Cancer

SummaryContemporary data from population studies on the incidence and complications of venous thromboembolism (VTE) are limited. An observational cohort study was undertaken to estimate the incidence of first and recurrent VTE. The cohort was identified from all patients in the UK Clinical Practice Research Datalink (CPRD) with additional linked information on hospitalisation and cause of death. Between 2001 and 2011, patients with first VTE were identified and the subset without active cancer-related VTE observed for up to 10 years for recurrent VTE. The 10-year cumulative incidence rates (CIR) were derived with adjustment for mortality as a competing risk event. A total of 35,373 first VTE events (12,073 provoked, 16,708 unprovoked and 6592 active cancer-associated VTE) among 26.9 million person-years of observation were identified. The overall incidence rate (IR) of VTE was 131.5 (95% CI, 130.2–132.9) per 100,000 person-years and 107.0 (95% CI, 105.8–108.2) after excluding cancer-associated VTE. DVT was more common in the young and PE was more common in the elderly. VTE recurrence occurred in 3671 (CIR 25.2%). The IR for recurrence peaked in the first six months at around 11 per 100 person years. It levelled out after three years and then remained at around 2 per 100 person years from year 4–10 of follow-up. The IRs for recurrences were particularly high in young men. In conclusion, VTE is common and associated with high recurrence rates. Effort is required to prevent VTE and to reduce recurrences.

scholarly journals Venous thromboembolism and subsequent risk of cancer in patients with liver disease: a population-based cohort study

2015 ◽  
Vol 2 (1) ◽  
pp. e000043 ◽  
Author(s):  
Jonathan Montomoli ◽  
Rune Erichsen ◽  
Kirstine Kobberøe Søgaard ◽  
Dóra Körmendiné Farkas ◽  
Anna-Marie Bloch Münster ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Venous Thromboembolism ◽  
Population Based ◽  
Risk Of Cancer ◽  
Subsequent Risk

scholarly journals Comorbidity and risk of venous thromboembolism after hospitalization for first‐time myocardial infarction: A population‐based cohort study

2020 ◽  
Vol 18 (8) ◽  
pp. 1974-1985
Author(s):  
Morten Würtz ◽  
Erik Lerkevang Grove ◽  
Priscila Corraini ◽  
Kasper Adelborg ◽  
Jens Sundbøll ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Population Based ◽  
First Time

Risk of Severe Maternal Morbidity or Death in Relation to Prenatal Biochemical Screening: Population-Based Cohort Study

2019 ◽  
Vol 38 (01) ◽  
pp. 044-059 ◽  
Author(s):  
Eric J.M. Lentz ◽  
Alison L. Park ◽  
Alec W.R. Langlois ◽  
Tianhua Huang ◽  
Wendy S. Meschino ◽  
...  
Keyword(s):  
Cohort Study ◽  
Maternal Mortality ◽  
Maternal Morbidity ◽  
Protein A ◽  
Population Based ◽  
Severe Maternal Morbidity ◽  
Adjusted Relative Risk ◽  
Biochemical Screening ◽  
High Concentration ◽  
Increased Risk

Abstract Objective This study aimed to examine whether prenatal biochemical screening analytes are associated with an increased risk of severe maternal morbidity (SMM) or maternal mortality. Study Design This population-based cohort study includes all women in Ontario, Canada, who underwent prenatal screening from 2001 to 2011. Increasing fifth percentiles of the multiple of the median (MoM) for alphafetoprotein (AFP), total human chorionic gonadotropin, unconjugated estriol (uE3), dimeric inhibin-A (DIA), and pregnancy-associated plasma protein A were evaluated. An abnormally high concentration (>95th percentile MoM) for each analyte, individually and combined, was also evaluated. The main outcome assessed was the adjusted relative risk (aRR) of SMM or maternal mortality from 20 weeks' gestation up to 26 weeks thereafter. Results Among 748,972 pregnancies, 11,177 resulted in SMM or maternal mortality (1.5%). Except for uE3, the aRR of SMM or maternal mortality increased in association with increasing fifth percentiles of the MoM for all analytes. AFP (aRR: 2.10; 95% confidence interval [CI]: 1.97–2.25) and DIA (aRR: 2.33; 95% CI: 1.98–2.74) > 95th versus ≤ 5th percentile of the MoM were especially associated with SMM or death. Conclusion Women with abnormally high concentrations of certain prenatal biochemical analytes may be at a higher risk of SMM or death in pregnancy or postpartum.

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