The team considered many patient factors: age, body mass index (BMI), gender, race, pre-existing conditions, medical history, smoking and others. The group also factored in different approaches to surgeryabdominal, thoracic, laparoscopic, etc. as well as the specific procedure type such as gastrointestinal, hernia, bariatric, splenectomy or lung. They also looked at post-operative complications, as these could affect both the length of stay and blood clot prevention efforts.
"There are a multitude of factors that go into whether a patient is at risk for VTE, as well as how to prevent it," said Canter. "Prior to this study, no one had ever looked at so many of these factors so comprehensively."
Overall, 1.5 percent of patients experienced a blood clot before discharge, while .5 percent experienced one after discharge. These rates were very consistent throughout the study years. A variety of factors were associated with increased blood clot risk, including age, high BMI, preoperative infection, cancer and non-bariatric laparoscopic surgery. Splenectomies carried the highest risk for blood clot, while bariatric surgeries had a lower incidence. In addition, major complications after surgery raised the incidence of VTEDC.
Perhaps most significant, the risks indicated by the study deviate sharply from current Joint Commission risk appraisals. For example, based on the study's findings, a patient with a history of colon cancer who is having his colon partially removed laparoscopically to treat recurrent cancer has a 10 percent chance of suffering a blood clot. Meanwhile, a patient having an emergency hernia repair has less than a 5 percent risk. Under current guidelines,
|Contact: Dorsey Griffith|
University of California - Davis Health System