Incidence and risk factors for venous thromboembolism in bilateral breast reduction surgery: An analysis of the National Surgical Quality Improvement Program

Gustavo A. Rubio, Yasmina Zoghbi, Charles A. Karcutskie, Seth Thaller

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The risk of venous thromboembolism (VTE) in patients undergoing bilateral breast reduction surgery remains unknown. This study aimed to determine VTE incidence and risk factors in this patient cohort. Methods: American College of Surgeons National Surgical Quality Improvement Program (2010-2014) was used to identify women undergoing bilateral breast reduction. Demographic factors, comorbidities, and incidence of postoperative VTE were evaluated. Bivariate and risk-adjusted multivariate logistic regressions were performed to determine factors associated with the development of postoperative VTE. Results: A total of 5371 cases were identified. The mean age was 43.7 years (SD ± 13.9 years). The rate of VTE was 0.22%, with 0.17% rate of pulmonary embolism and 0.07% rate of deep venous thrombosis requiring treatment. Patients who suffered VTE were older (52.4 ± 12.8 vs. 43.7 ± 13.9 years, p < 0.05), had longer length of stay (1.7 ± 2.9 vs. 0.4 ± 2.1 days, p < 0.05), and had higher rates of blood transfusion (8.3% vs. 0.4%, p < 0.01) and reoperation (16.7% vs. 2.0%, p < 0.01). Risk-adjusted multivariate analysis demonstrated that older age (OR 1.05, 95% CI 1.01-1.10), postoperative blood transfusion (OR 12.1, 95% CI 1.3-112.0) and unplanned return to the operating room (OR 6.7, 95% CI 1.3-34.8) were independent risk factors for developing postoperative VTE. Conclusion: In bilateral breast reduction surgery, older patients, patients requiring blood transfusion, and patients who have unplanned return to the operating room are at an increased risk of developing postoperative VTE. These factors can be considered for patient risk-stratification and perioperative decision-making regarding VTE prevention.

Original languageEnglish (US)
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
DOIs
StateAccepted/In press - 2017

Fingerprint

Venous Thromboembolism
Quality Improvement
Breast
Incidence
Blood Transfusion
Operating Rooms
Pulmonary Embolism
Reoperation
Venous Thrombosis
Comorbidity
Length of Stay
Decision Making
Multivariate Analysis
Logistic Models
Demography

Keywords

  • Bilateral breast reduction
  • Deep venous thrombosis
  • NSQIP
  • Pulmonary embolism
  • Reduction mammaplasty
  • Venous thromboembolism

ASJC Scopus subject areas

  • Surgery

Cite this

@article{166989bbd90244baa49bcd00b31e0640,
title = "Incidence and risk factors for venous thromboembolism in bilateral breast reduction surgery: An analysis of the National Surgical Quality Improvement Program",
abstract = "Background: The risk of venous thromboembolism (VTE) in patients undergoing bilateral breast reduction surgery remains unknown. This study aimed to determine VTE incidence and risk factors in this patient cohort. Methods: American College of Surgeons National Surgical Quality Improvement Program (2010-2014) was used to identify women undergoing bilateral breast reduction. Demographic factors, comorbidities, and incidence of postoperative VTE were evaluated. Bivariate and risk-adjusted multivariate logistic regressions were performed to determine factors associated with the development of postoperative VTE. Results: A total of 5371 cases were identified. The mean age was 43.7 years (SD ± 13.9 years). The rate of VTE was 0.22{\%}, with 0.17{\%} rate of pulmonary embolism and 0.07{\%} rate of deep venous thrombosis requiring treatment. Patients who suffered VTE were older (52.4 ± 12.8 vs. 43.7 ± 13.9 years, p < 0.05), had longer length of stay (1.7 ± 2.9 vs. 0.4 ± 2.1 days, p < 0.05), and had higher rates of blood transfusion (8.3{\%} vs. 0.4{\%}, p < 0.01) and reoperation (16.7{\%} vs. 2.0{\%}, p < 0.01). Risk-adjusted multivariate analysis demonstrated that older age (OR 1.05, 95{\%} CI 1.01-1.10), postoperative blood transfusion (OR 12.1, 95{\%} CI 1.3-112.0) and unplanned return to the operating room (OR 6.7, 95{\%} CI 1.3-34.8) were independent risk factors for developing postoperative VTE. Conclusion: In bilateral breast reduction surgery, older patients, patients requiring blood transfusion, and patients who have unplanned return to the operating room are at an increased risk of developing postoperative VTE. These factors can be considered for patient risk-stratification and perioperative decision-making regarding VTE prevention.",
keywords = "Bilateral breast reduction, Deep venous thrombosis, NSQIP, Pulmonary embolism, Reduction mammaplasty, Venous thromboembolism",
author = "Rubio, {Gustavo A.} and Yasmina Zoghbi and Karcutskie, {Charles A.} and Seth Thaller",
year = "2017",
doi = "10.1016/j.bjps.2017.05.050",
language = "English (US)",
journal = "Journal of Plastic, Reconstructive and Aesthetic Surgery",
issn = "1748-6815",
publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Incidence and risk factors for venous thromboembolism in bilateral breast reduction surgery

T2 - An analysis of the National Surgical Quality Improvement Program

AU - Rubio, Gustavo A.

AU - Zoghbi, Yasmina

AU - Karcutskie, Charles A.

AU - Thaller, Seth

PY - 2017

Y1 - 2017

N2 - Background: The risk of venous thromboembolism (VTE) in patients undergoing bilateral breast reduction surgery remains unknown. This study aimed to determine VTE incidence and risk factors in this patient cohort. Methods: American College of Surgeons National Surgical Quality Improvement Program (2010-2014) was used to identify women undergoing bilateral breast reduction. Demographic factors, comorbidities, and incidence of postoperative VTE were evaluated. Bivariate and risk-adjusted multivariate logistic regressions were performed to determine factors associated with the development of postoperative VTE. Results: A total of 5371 cases were identified. The mean age was 43.7 years (SD ± 13.9 years). The rate of VTE was 0.22%, with 0.17% rate of pulmonary embolism and 0.07% rate of deep venous thrombosis requiring treatment. Patients who suffered VTE were older (52.4 ± 12.8 vs. 43.7 ± 13.9 years, p < 0.05), had longer length of stay (1.7 ± 2.9 vs. 0.4 ± 2.1 days, p < 0.05), and had higher rates of blood transfusion (8.3% vs. 0.4%, p < 0.01) and reoperation (16.7% vs. 2.0%, p < 0.01). Risk-adjusted multivariate analysis demonstrated that older age (OR 1.05, 95% CI 1.01-1.10), postoperative blood transfusion (OR 12.1, 95% CI 1.3-112.0) and unplanned return to the operating room (OR 6.7, 95% CI 1.3-34.8) were independent risk factors for developing postoperative VTE. Conclusion: In bilateral breast reduction surgery, older patients, patients requiring blood transfusion, and patients who have unplanned return to the operating room are at an increased risk of developing postoperative VTE. These factors can be considered for patient risk-stratification and perioperative decision-making regarding VTE prevention.

AB - Background: The risk of venous thromboembolism (VTE) in patients undergoing bilateral breast reduction surgery remains unknown. This study aimed to determine VTE incidence and risk factors in this patient cohort. Methods: American College of Surgeons National Surgical Quality Improvement Program (2010-2014) was used to identify women undergoing bilateral breast reduction. Demographic factors, comorbidities, and incidence of postoperative VTE were evaluated. Bivariate and risk-adjusted multivariate logistic regressions were performed to determine factors associated with the development of postoperative VTE. Results: A total of 5371 cases were identified. The mean age was 43.7 years (SD ± 13.9 years). The rate of VTE was 0.22%, with 0.17% rate of pulmonary embolism and 0.07% rate of deep venous thrombosis requiring treatment. Patients who suffered VTE were older (52.4 ± 12.8 vs. 43.7 ± 13.9 years, p < 0.05), had longer length of stay (1.7 ± 2.9 vs. 0.4 ± 2.1 days, p < 0.05), and had higher rates of blood transfusion (8.3% vs. 0.4%, p < 0.01) and reoperation (16.7% vs. 2.0%, p < 0.01). Risk-adjusted multivariate analysis demonstrated that older age (OR 1.05, 95% CI 1.01-1.10), postoperative blood transfusion (OR 12.1, 95% CI 1.3-112.0) and unplanned return to the operating room (OR 6.7, 95% CI 1.3-34.8) were independent risk factors for developing postoperative VTE. Conclusion: In bilateral breast reduction surgery, older patients, patients requiring blood transfusion, and patients who have unplanned return to the operating room are at an increased risk of developing postoperative VTE. These factors can be considered for patient risk-stratification and perioperative decision-making regarding VTE prevention.

KW - Bilateral breast reduction

KW - Deep venous thrombosis

KW - NSQIP

KW - Pulmonary embolism

KW - Reduction mammaplasty

KW - Venous thromboembolism

UR - http://www.scopus.com/inward/record.url?scp=85021220308&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021220308&partnerID=8YFLogxK

U2 - 10.1016/j.bjps.2017.05.050

DO - 10.1016/j.bjps.2017.05.050

M3 - Article

C2 - 28655514

AN - SCOPUS:85021220308

JO - Journal of Plastic, Reconstructive and Aesthetic Surgery

JF - Journal of Plastic, Reconstructive and Aesthetic Surgery

SN - 1748-6815

ER -