Hospital Pharmacy Services, Mayo Clinic, Rochester, MN, USA.
Ann Surg Oncol. 2012 Oct;19(10):3230-5. doi: 10.1245/s10434-012-2524-y. Epub 2012 Jul 21.
The purposes of this study are (1) to determine our institution's rate of venous thromboembolic events (VTE) and hematomas following breast surgery, and (2) to compare our breast surgery VTE rate with both our general surgery population and the National surgical quality improvement program (NSQIP) dataset.
Prospectively collected NSQIP data from April 2006 to June 2010 were analyzed. Our institution's VTE rates, pharmacologic prophylaxis (PCP) utilization, and hematomas were reviewed for patients undergoing breast surgery. The VTE rate was compared with NSQIP patient populations.
Among 4,579 breast operations at our institution over this time period, 988 (21.6 %) were analyzed through NSQIP. The VTE rate following breast operations was 4/988 (0.4 %): 0/236 for those with benign disease and 4/752 (0.5 %) for those with breast cancer (p = 0.58). PCP was received by 147/752 (19.5 %) cancer patients. In cancer patients, the hematoma rate requiring reoperation was 3/147 (2.0 %) in those receiving PCP and 12/605 (2.0 %) in those not receiving PCP (p = 1.0). Breast surgery patients had a similar VTE rate compared with the institutional general surgery population (0.7 %, p = 0.254) and versus national general surgery patients from NSQIP (0.7 %, p = 0.29). Our institution's VTE incidence for patients with breast cancer undergoing mastectomy was significantly higher than "like" NSQIP centers.
Our breast surgery VTE rate was similar to our general surgery population. Our mastectomy population had a higher VTE incidence compared with other NSQIP sites. Patients undergoing mastectomy, especially if combined with axillary lymph node dissection or reconstruction, should be considered for routine PCP.
本研究的目的是：(1)确定我们机构在接受乳房手术后发生静脉血栓栓塞事件(VTE)和血肿的发生率，以及(2)将我们的乳房手术 VTE 发生率与我们的普通外科人群和国家外科质量改进计划(NSQIP)数据集进行比较。
对 2006 年 4 月至 2010 年 6 月期间前瞻性收集的 NSQIP 数据进行了分析。我们机构对接受乳房手术的患者的 VTE 发生率、药物预防(PCP)使用率和血肿进行了回顾性研究。并将 VTE 发生率与 NSQIP 患者人群进行了比较。
在这段时间内，我们机构共进行了 4579 例乳房手术，其中 988 例通过 NSQIP 进行了分析。接受乳房手术后的 VTE 发生率为 4/988(0.4%)：良性疾病患者为 0/236，乳腺癌患者为 4/752(0.5%)(p=0.58)。接受乳腺癌手术的患者中，147/752(19.5%)接受了 PCP。在接受 PCP 的患者中，有 3/147(2.0%)需要再次手术治疗血肿，而在未接受 PCP 的患者中，有 12/605(2.0%)(p=1.0)。与本机构普通外科人群相比(0.7%，p=0.254)，以及与 NSQIP 中全国普通外科患者相比(0.7%，p=0.29)，接受乳房手术的患者 VTE 发生率相似。我们机构接受乳腺癌根治术的患者 VTE 发生率明显高于其他 NSQIP 中心。
我们的乳房手术 VTE 发生率与普通外科人群相似。我们的乳腺癌根治术患者的 VTE 发生率高于其他 NSQIP 站点。接受乳腺癌根治术的患者，尤其是接受腋窝淋巴结清扫或重建的患者，应考虑常规使用 PCP。
