Venous thromboembolism in emergency general surgery patients: a single-centre retrospective cohort study

Background: There is limited literature on the risk of venous thromboembolism (VTE) in emergency general surgery (EGS) patients. We undertook this study to identify the rate of symptomatic VTE for patients undergoing EGS operations. Methods: We conducted a retrospective cohort study evaluating EGS patients who underwent operative intervention between March and December 2014. Data collected included patient demographics, type of procedure, risk of VTE, VTE prophylaxis, development of symptomatic VTE, and mortality. Results: We included 767 patients in our analysis. The mean age was 53 [+ or -] 19.7 years, and 52.2% of patients were female. Eighteen patients (2.3%) experienced VTE in hospital and 12 (1.6%) experienced VTE after discharge. Only 66% of patients received appropriate VTE prophylaxis. High-risk patients had a higher VTE rate (7.4% v. 2.3%, p < 0.001) and higher mortality (17.6% v. 4.0%, p < 0.001) than lowto moderate-risk patients. Conclusion: The risk of VTE in patients requiring EGS is significant and persists after hospital discharge. Further studies on quality improvement with VTE prophylaxis are warranted. Contexte : La litterature sur le risque de thromboembolie veineuse (TEV) chez les patients soumis a une chirurgie generale urgente est limitee. Nous avons entrepris cette etude afin de mesurer le taux de TEV symptomatique chez les patients ayant subi une intervention urgente en chirurgie generale. Methodes : Nous avons procede a une etude de cohorte retrospective sur les patients qui ont subi une chirurgie generale urgente entre mars et decembre 2014. Parmi les donnees recueillies, mentionnons donnees demographiques, type d'intervention, risque de TEV, thromboprophylaxie, apparition d'une TEV symptomatique et mortalite. Resultats : Nous avons inclus 767 patients dans notre analyse. L'age moyen etait de 53 [+ or -] 19,7 ans et 52,2 % des patients etaient de sexe feminin. Dix-huit patients (2,3 %) ont presente une TEV en cours d'hospitalisation et 12 (1,6 %) apres leur conge. Seulement 66 % des patients ont recu une thromboprophylaxie adequate. Les patients a haut risque ont presente des taux de TEV (7,4 % c. 2,3 %, p < 0,001) et de mortalite (17,6 % c. 4,0 %, p < 0,001) plus eleves que les patients presentant un risque faible a modere. Conclusion : Le risque de TEV chez les patients soumis a une chirurgie generale urgente est significatif et persiste apres le conge hospitalier. Il faudra mener des etudes plus approfondies sur l'amelioration de la qualite de la thromboprophylaxie.
The reported incidence of venous thromboembolism (VTE) has been on the rise. There is significant morbidity and mortality associated with the development of VTE, including prolonged hospital admission, risk of [...]