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10.1097/SLA.0b013e3182519ccf

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C4496245!4496245 !22584630
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suck abstract from ncbi


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pmid22584630
      Ann+Surg 2012 ; 255 (6 ): 1093-9
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  • Identifying patients at high risk for venous thromboembolism requiring treatment after outpatient surgery #MMPMID22584630
  • Pannucci CJ ; Shanks A ; Moote MJ ; Bahl V ; Cederna PS ; Naughton NN ; Wakefield TW ; Henke PK ; Campbell DA ; Kheterpal S
  • Ann Surg 2012[Jun]; 255 (6 ): 1093-9 PMID22584630 show ga
  • OBJECTIVE: To identify independent predictors of 30-day venous thromboembolism (VTE) events requiring treatment after outpatient surgery. BACKGROUND: An increasing proportion of surgical procedures are performed in the outpatient setting. The incidence of VTE requiring treatment after outpatient surgery is unknown. METHODS: Prospective observational cohort study using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2009. Adult patients who had outpatient surgery or surgery with subsequent 23-hour observation were included. The main outcome measure was 30-day VTE requiring treatment. Patients were randomly assigned to derivation (N = 173,501) or validation (N = 85,730) cohorts. Logistic regression examined independent risk factors for 30-day VTE. A weighted risk index was created and applied to the validation cohort. Stratified analyses examined 30-day VTE by risk level. RESULTS: Thirty-day incidence of VTE for the overall cohort was 0.15%. Independent risk factors included current pregnancy (adjusted odds ratio [OR] = 7.80, P = 0.044), active cancer (OR = 3.66, P = 0.005), age 41 to 59 years (OR = 1.72, P = 0.008), age 60 years or more (OR = 2.48, P < 0.001), body mass index 40 kg/m or higher (OR = 1.81, P = 0.015), operative time 120 minutes or more (OR = 1.69, P = 0.027), arthroscopic surgery (OR = 5.16, P < 0.001), saphenofemoral junction surgery (OR = 13.20, P < 0.001), and venous surgery not involving the great saphenous vein (OR = 15.61, P < 0.001). The weighted risk index identified a 20-fold variation in 30-day VTE between low (0.06%) and highest risk (1.18%) patients. CONCLUSIONS: Thirty-day VTE risk after outpatient surgery can be quantified using a weighted risk index. The risk index identifies a high-risk subgroup of patients with 30-day VTE rates of 1.18%.
  • |Adult [MESH]
  • |Ambulatory Surgical Procedures/*adverse effects [MESH]
  • |Databases, Factual [MESH]
  • |Female [MESH]
  • |Forecasting [MESH]
  • |Humans [MESH]
  • |Logistic Models [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Pregnancy [MESH]
  • |Prospective Studies [MESH]
  • |Random Allocation [MESH]
  • |Risk Assessment [MESH]
  • |Risk Factors [MESH]
  • |Treatment Outcome [MESH]


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