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10.1097/SLA.0b013e3182519ccf

http://scihub22266oqcxt.onion/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 PMID22584630show ga
  • Objective: To identify independent predictors of 30-day VTE events requiring treatment after outpatient surgery. Summary Background Data: An increasing proportion of surgical procedures are performed in the outpatient setting. The incidence of venous thromboembolism (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?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: 30-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?59 (OR 1.72, p=0.008), age ?60 (OR 2.48, p<0.001), body mass index ?40 (OR 1.81, p=0.015), operative time ?120 minutes (OR 1.69, p=0.027), arthroscopic surgery (OR 5.16, p<0.001), sapheno-femoral 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: 30-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%.
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