Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC.
Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, NC; Department of Public Health, Brody School of Medicine at East Carolina University, Greenville, NC.
Surgery. 2021 Dec;170(6):1770-1776. doi: 10.1016/j.surg.2021.06.040. Epub 2021 Jul 27.
Recent evidence suggests an increased incidence of venous thromboembolism among cancer patients of Black race. This study aimed to determine whether Black patients undergoing major oncologic resection experience increased rates of postoperative venous thromboembolism.
A cohort study of patients who underwent major oncologic resection was performed using American College of Surgeons National Surgical Quality Improvement Program (2016-2018). Primary outcome was venous thromboembolism within 30 days of surgery. Multivariable logistic regression was performed to evaluate the independent association of race and venous thromboembolism.
Of 91,707 patients, 67.7% were White, 9.5% Black, and 22.9% other race. Venous thromboembolism rates differed slightly by race: 2.2% among Whites, 2.4% Blacks, and 1.8% other (P = .002). Black patients were older, with higher rates of obesity, diabetes, and smoking. By multivariable logistic regression, risk of venous thromboembolism was lower among patients of other compared with White race (odds ratio 0.83; 95% confidence interval, 0.74-0.94). There was no difference in odds of venous thromboembolism among Black relative to White patients (odds ratio 1.08; 95% confidence interval, 0.93-1.26). When stratified by age, rates of venous thromboembolism were >50% higher among Black patients older than 75 years compared with White patients (odds ratio 1.54; 95% confidence interval, 1.17-2.03).
Despite evidence that Black patients with cancer experience higher rates of venous thromboembolism, they do not appear to have an increased risk in the postoperative period.
最近的证据表明，黑种人癌症患者静脉血栓栓塞的发病率增加。本研究旨在确定接受主要肿瘤切除术的黑种患者是否会增加术后静脉血栓栓塞的发生率。
使用美国外科医师学会国家手术质量改进计划（2016-2018 年）对接受主要肿瘤切除术的患者进行队列研究。主要结局是术后 30 天内静脉血栓栓塞。采用多变量逻辑回归评估种族与静脉血栓栓塞的独立关联。
在 91707 名患者中，67.7%为白人，9.5%为黑人，22.9%为其他种族。静脉血栓栓塞的发生率略有不同：白人 2.2%，黑人 2.4%，其他种族 1.8%（P=0.002）。黑人患者年龄较大，肥胖、糖尿病和吸烟的比例较高。通过多变量逻辑回归，与白人种族相比，其他种族患者的静脉血栓栓塞风险较低（优势比 0.83；95%置信区间，0.74-0.94）。黑人患者与白人患者相比，静脉血栓栓塞的风险无差异（优势比 1.08；95%置信区间，0.93-1.26）。按年龄分层，75 岁以上的黑人患者静脉血栓栓塞的发生率比白人患者高 50%以上（优势比 1.54；95%置信区间，1.17-2.03）。
尽管有证据表明患有癌症的黑种人静脉血栓栓塞的发生率较高，但他们在术后期间似乎没有增加的风险。
