Journal article
Postoperative venous thromboembolism risk in patients with vulvar carcinoma: An analysis of the National surgical Quality Improvement Program (NSQIP) database
Gynecologic oncology reports, Vol.54, 101411
08/2024
DOI: 10.1016/j.gore.2024.101411
PMCID: PMC11128827
PMID: 38803657
Abstract
•VTE is a rare, but potentially lethal postoperative complication in vulvar cancer patients undergoing surgical management.•Increased operating time, functional dependence, deep surgical site infection, and thrombocytosis increase risk for VTE.•Identifying these risks is important in determining which patients would benefit from postoperative VTE prophylaxis.
Due to low incidence of vulvar cancer (VC), incidence and predictors for development of venous thromboembolism (VTE) are poorly understood. We examined incidence and risk factors associated with VTE in patients undergoing surgery for VC.
We included patients who underwent surgery for VC from the National Surgical Quality Improvement Program database. VTE within the 30-day postoperative period was captured with Current Procedural Terminology codes. Baseline demographics and clinical characteristics were compared between patients with and without VTE. Univariable and multivariable-adjusted exact logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between risk factors and VTE.
We identified 1414 patients undergoing procedures for VC from the NSQIP database. Overall, 11 (0.8 %) patients developed VTE. Univariable predictors of VTE included surgery type [compared with simple vulvectomy: radical vulvectomy only (OR = 7.97, 95 % CI = 1.44, infinity) and radical vulvectomy plus unilateral IFN (OR = 15.98, 95 % CI = 2.70, infinity)], unplanned readmission (OR = 11.56, 95 % CI = 2.74, 46.38), deep surgical site infection (OR = 16.05, 95 % CI = 1.59–85.50), and preoperative thrombocytosis (OR = 6.53, 95 % CI = 0.00, 34.86). In a multivariable-adjusted model, longer operative time (≥72 min OR = 11.33, 95 % CI = 1.58–499.03) and preoperative functional status [compared with complete independence: total dependence (OR = 53.88, 95 % CI = 0.85, infinity) and partial dependence (OR = 53.88, 95 % CI = 0.85, infinity)] were associated with VTE.
In this cohort of patients with VC undergoing radical vulvectomy, VTE incidence was low. Surgery type, longer operative time, dependent functional status, and wound disruption were identified as risk factors. Our findings highlight opportunities for prophylactic intervention in certain patients.
Details
- Title: Subtitle
- Postoperative venous thromboembolism risk in patients with vulvar carcinoma: An analysis of the National surgical Quality Improvement Program (NSQIP) database
- Creators
- Quinn Kistenfeger - The Ohio State UniversityAshley S. Felix - The Ohio State UniversityCaitlin E. Meade - The Ohio State UniversityVincent Wagner - University of IowaKristin Bixel - The Ohio State UniversityLaura M. Chambers - The Ohio State University
- Resource Type
- Journal article
- Publication Details
- Gynecologic oncology reports, Vol.54, 101411
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.gore.2024.101411
- PMID
- 38803657
- PMCID
- PMC11128827
- ISSN
- 2352-5789
- eISSN
- 2352-5789
- Grant note
- Doris Duke Charitable Foundation (DDCF): 2021258 John Templeton Foundation: 62288 Ohio State University National Center for Advancing Translational Sciences: UL1TR001070
This work was supported by Grant 2021258 for Laura Chambers, DO, from the Doris Duke Charitable Foundation (DDCF) through the COVID-19 Fund to Retain Clinical Scientists collaborative grant program and was made possible through the support of Grant 62288 from the John Templeton Foundation. The opinions expressed in this publication are those of the author (s) and do not necessarily reflect the view of the DDCF, the John Templeton Foundation, the OSU College of Medicine, or the Center for Clinical and Translational Science. Additionally, this project was supported by a Research Grant by a Path to K award from the Ohio State University College of Medicine Office of Research and the Center for Clinical & Translational Science through the Richard P. & Marie R. Bremer Medical Research Fund and William H. Davis Endow-ment for Basic Medical Research. The content is solely the authors' responsibility and does not necessarily reflect the views of the Davis/Bremer Research Fund, the CCTS, or The Ohio State University Medical Center. Additional grant support includes The Ohio State University National Center for Advancing Translational Sciences, Grant UL1TR001070, and The Pelotonia Institute for Immuno-Oncology.
- Language
- English
- Date published
- 08/2024
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9984628036102771
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