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49028 例乳房切除术患者静脉血栓栓塞的相关风险因素。

Risk factors associated with venous thromboembolism in 49,028 mastectomy patients.

机构信息

Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, 1510 San Pablo St., Suite 415, Los Angeles, CA 90033, USA.

出版信息

Breast. 2013 Aug;22(4):444-8. doi: 10.1016/j.breast.2013.04.018. Epub 2013 May 18.

Abstract

Venous thromboembolism (VTE) is a potentially preventable disease that carries significant morbidity and mortality. Although malignancy is associated with increased risk for VTE, it varies according to cancer type. Despite the fact that breast cancer is the most common form of cancer in women, the incidence and risk factors associated with VTE in patients undergoing mastectomy have not been well characterized. To address this we utilized the ACS-NSQIP database to identify and characterize independent risk factors for VTE in 49,028 mastectomy patients. We identified 116 cases of VTE in the 49,028 cases analyzed (0.23%). Obesity (BMI > 30, OR = 1.91, p < 0.001), inpatient status (OR = 3.75, p < 0.001), venous catheterization (OR = 2.67, p = 0.012), prolonged operative time >3 h (OR = 4.36, p < 0.001), and immediate reconstruction (OR = 3.23, p < 0.001) were found to be independent risk factors for VTE. While the incidence of VTE is rare in mastectomy patients, the heightened awareness and increased VTE prophylaxis should be considered in high risk groups.

摘要

静脉血栓栓塞症(VTE)是一种潜在可预防的疾病,具有显著的发病率和死亡率。虽然恶性肿瘤与 VTE 的风险增加相关,但它因癌症类型而异。尽管乳腺癌是女性最常见的癌症类型,但接受乳房切除术的患者中与 VTE 相关的发病率和风险因素尚未得到很好的描述。为了解决这个问题,我们利用 ACS-NSQIP 数据库在 49028 例乳房切除术患者中确定和描述 VTE 的独立风险因素。在分析的 49028 例病例中,我们发现了 116 例 VTE(0.23%)。肥胖(BMI > 30,OR = 1.91,p < 0.001)、住院状态(OR = 3.75,p < 0.001)、静脉置管(OR = 2.67,p = 0.012)、手术时间延长>3 小时(OR = 4.36,p < 0.001)和即刻重建(OR = 3.23,p < 0.001)被发现是 VTE 的独立风险因素。虽然乳房切除术患者中 VTE 的发病率较低,但在高危人群中应提高对 VTE 的认识并增加 VTE 的预防措施。

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