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World Journal of Surgery

, Volume 36, Issue 2, pp 280–286 | Cite as

Incidence and Prevention of Postoperative Venous Thromboembolism: Are They Meaningful Quality Indicators in Japanese Health Care Settings?

  • Susumu Kunisawa
  • Hiroshi Ikai
  • Yuichi ImanakaEmail author
Article

Abstract

Background

Venous thromboembolism (VTE) epidemiology varies widely across surgical procedures. At present, there are few epidemiologic reports regarding VTE in Japan. Japanese VTE prophylaxis guidelines recommend a risk-based approach based on previous epidemiologic statistics. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE). PE prevention is the main goal, although the relation between PE and DVT is still controversial.

Methods

We collected administrative data for 1,016,496 surgical patients from 260 hospitals. We analyzed DVT and PE incidence and selected two subgroups for further analysis: gastroenterologic surgery and specific orthopedic surgery (high-frequency group).

Results

Overall DVT incidence was 1947 (0.19%); and the PE incidence was 538 (0.05%). DVT case fatality rate was 3.44% (67/1947); that for PE was 22.86% (123/538). Both overall and subgroup incidences were comparable to those in previous reports. Subgroup analyses in the high-frequency group did not show a relation between DVT and PE. VTE prophylaxis did not show a relation between DVT and PE despite 99% adherence.

Conclusions

Our results are consistent with established data regarding DVT and PE incidence. Administrative data available in Japan provides a powerful epidemiologic tool to characterize rare diseases such as DVT and PE. DVT is not a suitable quality indicator in Japan. However, PE is too rare to be considered a rate-based outcome indicator, and VTE prophylaxis is too widely applied to be used as a process indicator. VTE measurement is not a useful quality indicator in Japan to compare hospitals but provides a longitudinal self-survey.

Keywords

Pulmonary Embolism Deep Vein Thrombosis Pulmonary Embolism Event Pulmonary Embolism Incidence Deep Vein Thrombosis Incidence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This study was supported in part by a Health Sciences Research Grant from the Ministry of Health, Labor, and Welfare of Japan and a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science.

Conflicts of interest

The authors declare that there are no potential or real conflicts of interest.

Supplementary material

268_2011_1229_MOESM1_ESM.pdf (20 kb)
Supplementary material 1 (PDF 21 kb)

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Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  1. 1.Department of Healthcare Economics and Quality Management, Graduate School of MedicineKyoto UniversitySakyou-kuJapan

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