Journal article
Is Preoperative Chemoprophylaxis Safe for Venous Thromboembolism Prevention in Patients With Head and Neck Cancer?
Otolaryngology-head and neck surgery, Vol.171(4), pp.1097-1105
10/08/2024
DOI: 10.1002/ohn.875
PMID: 38943444
Appears in UI Libraries Support Open Access
Abstract
Objective
To assess the safety of preoperative chemoprophylaxis (PEC) in head and neck cancer (HNC) patients undergoing oncologic procedures.
Study Design
Retrospective cohort study.
Setting
Tertiary academic center.
Methods
HNC patients with Caprini risk score (CRS) ≥5 who underwent inpatient surgery ≥3 hours between 2015 and 2020 were included. Patients were divided into 2 cohorts, PEC and control, based on whether or not they received a single dose of low molecular weight heparin or unfractionated heparin prior to surgery. The primary endpoint was the 30-day rate of major bleeding events.
Results
A total of 539 patients were included; 427 patients received PEC prior to surgery. The rate of major bleeding was 6.7%. The PEC cohort was more likely to have received concurrent aspirin or ketorolac (225 of 427 patients vs 36 of 112 patients; P = .0002), greater duration of chemoprophylaxis (7.8 vs 5.0 days; P < .0001), have higher CRS (7.2 vs 6.6; P < .0001), longer operative times (596 vs 512 minutes; P < .0001), higher blood loss (265 vs 214 ml; P = .02), and higher bleeding rates when compared to the control (34 of 427 patients; P = .03). On multivariate analysis, only PEC was associated with bleeding (odds ratio, 8.74; 95% confidence interval, 1.15-66.5). The rate of VTE was 1.3% and was not significantly different between cohorts.
Conclusion
PEC was associated with an increase in bleeding and did not result in lower rates of VTE in patients with HNC. This study highlights the need to determine the optimal regimen of chemoprophylaxis in this patient cohort.
Details
- Title: Subtitle
- Is Preoperative Chemoprophylaxis Safe for Venous Thromboembolism Prevention in Patients With Head and Neck Cancer?
- Creators
- Heba Isaac - University of IowaMark A Arnold - SUNY Upstate Medical UniversityNitin A Pagedar - University of IowaMarisa R Buchakjian - University of IowaKiranya E Arnold - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Otolaryngology-head and neck surgery, Vol.171(4), pp.1097-1105
- Publisher
- Wiley
- DOI
- 10.1002/ohn.875
- PMID
- 38943444
- ISSN
- 1097-6817
- eISSN
- 1097-6817
- Language
- English
- Electronic publication date
- 06/29/2024
- Date published
- 10/08/2024
- Academic Unit
- Psychological and Brain Sciences; Otolaryngology
- Record Identifier
- 9984649057602771
Metrics
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