Portal de Periódicos da CAPES

Timing and characteristics of venous thromboembolism after noncancer surgery

2020; Elsevier BV; Volume: 9; Issue: 4 Linguagem: Inglês

10.1016/j.jvsv.2020.11.017

2213-3348

Manuela Expósito Ruíz, Juan I. Arcelus, Joseph A. Caprini, C. López Espada, A. Bura-Rivière, Cristina Amado, Mónica Loring, Daniela Mastroiacovo, Manuel Monréal, Manuel Monréal, Paolo Prandoni, Benjamin Brenner, Dominique Farge, Raquel Barba, Pierpaolo Di Micco, Laurent Bertoletti, Sebastian Schellong, Inna Tzoran, Abílio Reis, Marijan Bosevski, H Bounameaux, Radován Malý, Peter Verhamme, Joseph A. Caprini, My Bui, María Dolores Adarraga, María Agud, Jesús Aibar, M.A. Aibar, Cristina Amado, Juan I. Arcelus, C. Baeza, Aitor Ballaz, Raquel Barba, C. Barbagelata, M. Barrón, B. Barrón‐Andrés, Á. Blanco-Molina, Enrique Ramón Botella, A.M. Camón, Stalin Campos, I. Cañas, I. Casado, Joaquín Castro, Juan Criado, Cristina de Ancos, Javier de Miguel‐Díez, J. del Toro, Pablo Demelo‐Rodríguez, Carmen Díaz‐Pedroche, J.A. Díaz‐Peromingo, J. Díez-Sierra, I.M. Domínguez, J.C. Escribano, C. Falgá, A.I. Farfán, K. Fernández de Roitegui, C. Fernández‐Aracil, Carmen Fernández‐Capitán, José Luis Fernández‐Reyes, M.A. Fidalgo, Katia Flores, Carme Font, Llorenç Font, Iria Francisco, I. Furest, Cristina Gabara, Francisco Galeano‐Valle, Marian García-Núñez, F. García‐Bragado, R. García-Hernáez, Aránzazu García‐Raso, Olga Gavín‐Sebastián, A. Gil-Díaz, Covadonga Gómez‐Cuervo, J. González‐Martínez, E Grau, M. Giménez-Suau, L. Guirado, Javier Cuesta, Luis Blasco, E. Rocha Hernando, Miguel Herreros, Luis Jara‐Palomares, M.J. Jaras, David Jiménez, Ricardo Marcelín‐Jiménez, M.D. Joya, I. Jou, Antonio Lalueza, R. Lecumberri, J. Lima, Pilar Llamas, J.L. Lobo, Luciano López‐Jiménez, Patricia López-Miguel, Juan J. López-Núñez, Raquel López-Reyes, J.B. López‐Sáez, A. García de Lorenzo, Mónica Loring, Olga Madridano, Ana Maestre, P.J. Marchena, M. Martín del Pozo, F. Martín‐Martos, C Mella, Meritxell Mellado, M.I. Mercado, Jorge Moisés, Manuel Monréal, M.V. Morales, Arturo Muñoz Blanco, Diego Muñoz-Guglielmetti, A. Rivas, J.A. Nieto, A. Núñez-Ares, M.J. Núñez-Fernández, Berta Obispo, M.C. Olivares, J.L. Orcastegui, M.D. Ortega-Recio, Jeisson Osorio, S. Otálora, Remedios Otero, Diana Paredes-Ruíz, Pedro Parra, Virginia Parra, José María Pedrajas, G. Pellejero, David Pesántez, José Antonio Porras, Joaquin Portillo, Antoni Riera‐Mestre, A. Rivas, F. Rivera, A. Rodríguez-Cobo, Consolación Rodríguez-Matute, Jacobo Rogado, V. Rosa, Carmen Ma. Rubio, Pedro Ruiz‐Artacho, N. Ruiz‐Giménez, Justo Ruiz-Ruiz, P. Ruiz-Sada, Joan Carles Sahuquillo, G. Salgueiro, A. Sampériz, J.F. Sánchez‐Muñoz‐Torrero, Teresa Sancho, Patricia Sigüenza, S. Soler, J.M. Suriñach, Marı́a Isabel Torres, C. Tolosa, J. Trujillo-Santos, Fernando Uresandi, R. Valle, J. Vela, G. Vidal, Paula Villares, C Zamora, Paula Gutiérrez, Francisco José Vázquez, Thomas Vanassche, Christophe Vandenbriele, Peter Verhamme, Jana Hirmerová, Radován Malý, I. Benzidia, Laurent Bertoletti, A. Bura-Rivière, Benjamin Crichi, P. Debourdeau, Olivier Espitia, Dominique Farge, H. L. Helfer, I. Mahé, F. Moustafa, Géraldine Poenou, Sebastian Schellong, Andrei Braester, Benjamin Brenner, Inna Tzoran, Franca Bilora, B. Brandolin, Eugenio Bucherini, Maurizio Ciammaichella, Donatella Colaizzo, Pierpaolo Di Micco, Elvira Grandone, Davide De Marchi, Daniela Mastroiacovo, R. Maida, F. Pace, Raffaele Pesavento, P. Prandoni, Roberto Quintavalla, Nunzio Rinzivillo, Anna Rocci, Carmine Siniscalchi, Antonella Tufano, A. Visonà, Beniamino Zalunardo, Valdis Ģībietis, Dana Kigitoviča, Andris Skride, Melanie Ferreira, S. Fonseca, Filipa Abreu Martins, J. Meireles, Marijan Bosevski, Gorjan Krstevski, H Bounameaux, Lucia Mazzolai, Joseph A. Caprini, Alfonso Tafur, Ido Weinberg, Hannah Wilkins, H.M. Bui,

Hemodynamic Monitoring and Therapy

Background Venous thromboembolism (VTE) is a major cause of morbidity and mortality postoperatively. The use of pharmacologic prophylaxis is effective in reducing the incidence of VTE. However, the prophylaxis is often discontinued at hospital discharge, especially for those with benign disease. The implications of this practice are not known. We assessed the data from a large, ongoing registry regarding the time course of VTE and outcomes after noncancer surgery. Methods We analyzed the RIETE (Computerized Registry on Venous Thromboembolism) registry, which includes data from consecutive patients with symptomatic confirmed VTE. In the present study, we focused on general surgical patients who had developed symptomatic postoperative VTE in the first 8 weeks after noncancer surgery. The main objective was to assess the interval between surgery and the occurrence of VTE. Additional variables included the clinical presentation associated with the event, the use of thrombosis prophylaxis, and unfavorable outcomes. Results The data from 3296 patients were analyzed. The median time from surgery to the detection of VTE was 16 days (interquartile range, 8-30 days). Of the VTE events, 77% were detected after the first postoperative week and 27% after 4 weeks. Overall, 43.9% of the patients with VTE had received pharmacologic prophylaxis after surgery for a median of 8 days (interquartile range, 5-14 days), and three quarters of the VTE events were detected after pharmacologic prophylaxis had been discontinued. Overall, 54% of the patients with VTE had presented with pulmonary embolism. For 15% of the patients, the clinical outcome was unfavorable, including 4% who had died within 90 days. Conclusions The risk of VTE after noncancer general surgery remains high for ≤2 months. More than one half of the patients had presented with symptomatic PE as the VTE event, and 15% had had unfavorable outcomes. Only 44% of these patients had received pharmacologic prophylaxis for around 1 week.