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Readmission rates due to venous thromboembolism in cancer patients after abdominopelvic surgery, a retrospective chart review

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Abstract

Purpose

Venous thromboembolism (VTE) is a known cause of morbidity in the oncology patient population. As hospital readmission rates are more frequently scrutinized, we sought to determine the most common causes of 30-day readmissions in the cancer patient following abdominopelvic surgery. Furthermore, due to the high risk of VTE, there have been guidelines established for prophylaxis. As guidelines are based on asymptomatic VTE, we studied the compliance rates of these guidelines in our institution and the rate of symptomatic VTE in the 30-day postoperative period.

Methods

We conducted a retrospective chart review at Pennsylvania Hospital of abdominopelvic surgeries between January 1, 2010 and December 31, 2012 in patients with abdominopelvic malignancies, totaling 263 patients.

Results

The median age of our patient population was 67 years and 51.3 % were female. The most common malignancy locations were colorectal (44 %) and pancreas (11 %). One patient did not receive perioperative anticoagulation; most received heparin subcutaneously three times daily, mean duration 5.5 days. Fourteen patients (5 %) received outpatient anticoagulation after discharge; only two had a primary intent of VTE prophylaxis. Thirty-five patients (13 %) were readmitted within 30 days of discharge, the most common reasons being abdominal symptoms and postoperative/surgical complications. There was one patient readmitted for a new, symptomatic VTE.

Conclusions

Our study showed only one new, symptomatic VTE in the study population, despite 95 % of patients not receiving outpatient anticoagulation, which suggests that continued larger and multicenter trials may be needed to study anticoagulation benefits and risks in this patient population.

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Abbreviations

VTE:

Venous thromboembolism

ASCO:

American Society of Clinical Oncology

UFH:

Unfractionated heparin

LMWH:

Low-molecular-weight heparin

DVT:

Deep venous thrombosis

UPHS:

University of Pennsylvania Health System

IRB:

Internal review board

BMI:

Body mass index

PE:

Pulmonary embolism

NOS:

Not otherwise specified

g:

Grams

dL:

Deciliter

L:

Liter

mg:

Milligrams

ACCP:

American College of Chest Physicians

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Conflict of interest

Authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Medicine, Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA, 19107, USA

    Christine Klimowicz White & David H. Henry

  2. Joan Karnell Cancer Center, Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA, 19107, USA

    Susan Kruse, Kimberly Sallee & David H. Henry

  3. Jefferson Medical College, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA, 19107, USA

    Jessica Langholtz

  4. Department of Zoology, University of Oxford, South Parks Road, Oxford, OX1 3PS, UK

    Zackory T. Burns

Authors
  1. Christine Klimowicz White
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  2. Jessica Langholtz
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  3. Zackory T. Burns
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  4. Susan Kruse
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  5. Kimberly Sallee
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  6. David H. Henry
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Correspondence to Christine Klimowicz White.

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White, C.K., Langholtz, J., Burns, Z.T. et al. Readmission rates due to venous thromboembolism in cancer patients after abdominopelvic surgery, a retrospective chart review. Support Care Cancer 23, 993–999 (2015). https://doi.org/10.1007/s00520-014-2448-0

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  • DOI: https://doi.org/10.1007/s00520-014-2448-0

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