Does the presence of thyroid cancer increase the risk of venous thromboembolism in patients undergoing thyroidectomy?

Caroline E Reinke; Rachel A Hadler; Giorgos C Karakousis; Douglas L Fraker; Rachel R Kelz

doi:10.1016/j.surg.2011.09.040

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Does the presence of thyroid cancer increase the risk of venous thromboembolism in patients undergoing thyroidectomy?

Journal article

Peer reviewed

Does the presence of thyroid cancer increase the risk of venous thromboembolism in patients undergoing thyroidectomy?

Caroline E Reinke, Rachel A Hadler, Giorgos C Karakousis, Douglas L Fraker and Rachel R Kelz

Surgery, Vol.150(6), pp.1275-1285

12/2011

DOI: 10.1016/j.surg.2011.09.040

PMID: 22136851

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Abstract

Venous thromboembolism (VTE) is a leading cause of postoperative morbidity and mortality in cancer patients. We evaluate the association between thyroid cancer (TCA) and VTE in thyroidectomy patients and assess the impact of TCA status on risk level using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Best Practices guideline. A retrospective cohort study of thyroidectomy patients using the ACS NSQIP database (2005-2008) was performed. Patients were stratified by the presence (TCA) or absence (non-TCA) of TCA. The incidence of 30-day postoperative VTE and VTE risk factors were compared between groups. Risk factor scores (RFS) for VTE were computed with and without TCA as a factor. Fifteen VTE events were documented in 19,640 patients. The incidence of VTE was 0.08% in the TCA and 0.07% in non-TCA groups (P = .783). TCA patients were younger, had a lower body mass index, and had longer operations than non-TCA patients. TCA patients had slightly higher RFS before inclusion of TCA (mean of 4.26 vs 4.16; P < .001). After adjustment for the RFS, TCA was not associated with an increased risk of VTE. TCA does not seem to be independently associated with VTE in patients undergoing thyroidectomy. The decision for anticoagulation should therefore be determined by individual patient risk factors.

Adult

Aged

Cohort Studies

Humans

Incidence

Logistic Models

Middle Aged

Multivariate Analysis

Postoperative Complications - epidemiology

Practice Guidelines as Topic

Retrospective Studies

Risk Factors

Thyroid Diseases - complications

Thyroid Diseases - surgery

Thyroid Neoplasms - complications

Thyroid Neoplasms - surgery

Thyroidectomy

Venous Thromboembolism - epidemiology

Venous Thromboembolism - etiology

Details

Title: Subtitle: Does the presence of thyroid cancer increase the risk of venous thromboembolism in patients undergoing thyroidectomy?
Creators: Caroline E Reinke - Hospital of the University of Pennsylvania
Rachel A Hadler - Hospital of the University of Pennsylvania
Giorgos C Karakousis - Hospital of the University of Pennsylvania
Douglas L Fraker - Hospital of the University of Pennsylvania
Rachel R Kelz - Hospital of the University of Pennsylvania
Resource Type: Journal article
Publication Details: Surgery, Vol.150(6), pp.1275-1285
DOI: 10.1016/j.surg.2011.09.040
PMID: 22136851
ISSN: 0039-6060
eISSN: 1532-7361
Language: English
Date published: 12/2011
Academic Unit: Anesthesia
Record Identifier: 9984295959202771

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