头颈部手术中的静脉血栓栓塞：国家层面的风险、结局及负担

Venous thromboembolism in head and neck surgery: Risk, outcome, and burden at the national level.

作者信息

Al-Qurayshi Zaid, Walsh Jarrett, Rodrigo Bayon, Kandil Emad

机构信息

Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.

出版信息

Head Neck. 2019 Feb;41(2):411-422. doi: 10.1002/hed.25409. Epub 2018 Dec 7.

DOI:10.1002/hed.25409

PMID:30536494

Abstract

BACKGROUND

Venous thromboembolism (VTE) can complicate major surgeries. This study examines the risk and outcomes of VTE in patients who underwent head and neck surgeries.

METHODS

Retrospective cross-sectional analysis utilizing the Nationwide Readmissions Database (2010-2014). Study population included adults (≥18 year) patients who underwent head and neck surgeries.

RESULTS

A total 386 VTE patients and 116 450 controls included. VTE risk was 0.37%, postoperative mortality was 4.87%. Of VTE, 57.02% identified within the initial admission for surgery, while the rest required readmission within 90 days. VTE high-risk surgeries included: major ear/skull base surgeries, major nose/paranasal sinuses surgeries, major mouth/tonsil surgeries, major salivary glands/ducts surgeries, major maxillofacial bones/mandible surgeries, and major and nonmajor pharynx and larynx surgeries (P < .05). Those same surgeries were also associated with a high risk of readmission (P < .05).

CONCLUSIONS

VTE is associated with a significant mortality risk. Surgeries that involve the pharynx and larynx have the highest risk of VTE and readmission.

摘要

背景

静脉血栓栓塞症（VTE）可使大手术出现并发症。本研究调查了接受头颈外科手术患者发生VTE的风险及后果。

方法

利用全国再入院数据库（2010 - 2014年）进行回顾性横断面分析。研究人群包括接受头颈外科手术的成年（≥18岁）患者。

结果

共纳入386例VTE患者和116450例对照。VTE风险为0.37%，术后死亡率为4.87%。在VTE患者中，57.02%在初次手术住院期间被确诊，其余患者在90天内需要再次入院。VTE高风险手术包括：耳部/颅底大手术、鼻/鼻窦大手术、口腔/扁桃体大手术、唾液腺/导管大手术、颌面骨/下颌骨大手术以及咽和喉的大手术与非大手术（P < 0.05）。这些手术也与再次入院的高风险相关（P < 0.05）。