Abstract
Background
The literature is sparse regarding the association between pneumonia and venous thrombosis in surgical patients. The aim of this study was to investigate the risk of postoperative venous thrombosis in patients who fit the criteria for preoperative pneumonia using data from the ongoing American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database while adjusting for potential confounders.
Methods
This is a cohort study using data from the ACS NSQIP database participating sites from 2008 (211 sites) and 2009 (237 sites). 427,656 patients undergoing major general surgery were included. The 30-day risk of postoperative venous thrombosis including deep vein thrombosis (DVT) and pulmonary embolism (PE) was evaluated in patients with preoperative pneumonia diagnosed before undergoing major general surgery.
Results
Patients with preoperative pneumonia had a higher incidence of both 30-day DVT and PE than patients without preoperative pneumonia. After adjusting for all potential confounders, the effect estimates for the association between preoperative pneumonia and venous thrombosis were DVT, OR: 1.67 (95% CI 1.32–2.11) and PE, OR: 2.18 (95% CI 1.48–3.22).
Conclusions
A large, multicenter database of surgical patients showed that preoperative pneumonia may increase risk for developing venous thrombosis. This adds to our understanding of risk factors for venous thrombosis and suggests a potential benefit of diagnosing preoperative pneumonia in patients undergoing major general surgery.
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References
Shorr AF, Sarnes MW, Peeples PJ et al (2007) Comparison of cost, effectiveness, and safety of injectable anticoagulants used for thromboprophylaxis after orthopedic surgery. Am J Health Syst Pharm 64:2349–2355
Geerts WH, Pineo GF, Heit JA et al (2004) Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:338S–400S
Quist-Paulsen P, Naess IA, Cannegieter SC et al (2010) Arterial cardiovascular risk factors and venous thrombosis: results from a population-based, prospective study (the HUNT 2). Haematologica 95:119–125
Fox EA, Kahn SR (2005) The relationship between inflammation and venous thrombosis. A systematic review of clinical studies. Thromb Haemost 94:362–365
Tichelaar YI, Kluin-Nelemans HJ, Meijer K (2012) Infections and inflammatory diseases as risk factors for venous thrombosis. A systematic review. Thromb Haemost 107:827–837
Gangireddy C, Rectenwald JR, Upchurch GR et al (2007) Risk factors and clinical impact of postoperative symptomatic venous thromboembolism. J Vasc Surg 45:335–341 discussion 341–332
Musallam KM, Tamim HM, Richards T et al (2011) Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study. Lancet 378:1396–1407
Khuri SF, Henderson WG, Daley J et al (2007) The patient safety in surgery study: background, study design, and patient populations. J Am Coll Surg 204:1089–1102
Fink AS, Campbell DA Jr, Mentzer RM Jr et al (2002) The National Surgical Quality Improvement Program in non-veterans administration hospitals: initial demonstration of feasibility. Ann Surg 236:344–353 discussion 353–344
Yang C, Huang N, Shi B (2011) Clinical research of presurgical orthodontic treatment of complete cleft lip and palate infant. Hua Xi Kou Qiang Yi Xue Za Zhi 29:396–399
Agnelli G, Bolis G, Capussotti L et al (2006) A clinical outcome-based prospective study on venous thromboembolism after cancer surgery: the @RISTOS project. Ann Surg 243:89–95
Clayton TC, Gaskin M, Meade TW (2011) Recent respiratory infection and risk of venous thromboembolism: case–control study through a general practice database. Int J Epidemiol 40:819–827
Schmidt M, Horvath-Puho E, Thomsen RW et al (2012) Acute infections and venous thromboembolism. J Intern Med 271:608–618
Ribeiro DD, Lijfering WM, Van Hylckama Vlieg A et al (2012) Pneumonia and risk of venous thrombosis: results from the MEGA study. J Thromb Haemost 10:1179–1182
Gross ME, Vogler SA, Mone MC et al (2014) The importance of extended postoperative venous thromboembolism prophylaxis in IBD: a National Surgical Quality Improvement Program analysis. Dis Colon Rectum 57:482–489
Smeeth L, Cook C, Thomas S et al (2006) Risk of deep vein thrombosis and pulmonary embolism after acute infection in a community setting. Lancet 367:1075–1079
Monn MF, Hui X, Lau BD et al (2014) Infection and venous thromboembolism in patients undergoing colorectal surgery: what is the relationship? Dis Colon Rectum 57(4):497–505
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Masrouha, K.Z., Musallam, K.M., Rosendaal, F.R. et al. Preoperative Pneumonia and Postoperative Venous Thrombosis: A Cohort Study of 427,656 Patients Undergoing Major General Surgery. World J Surg 40, 1288–1294 (2016). https://doi.org/10.1007/s00268-016-3409-1
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DOI: https://doi.org/10.1007/s00268-016-3409-1