Age- and sex-specific incidence, risk, and latency period of a perioperative acute thromboembolism syndrome (PATS)

Mutsuhito Kikura; Tomosue Takada; Shigehito Sato

doi:10.1160/TH03-10-0613

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2004; 91(04): 725-732
DOI: 10.1160/TH03-10-0613

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Age- and sex-specific incidence, risk, and latency period of a perioperative acute thromboembolism syndrome (PATS)

Mutsuhito Kikura

¹Staff Anesthesiologist, Department of Anesthesiology and Pain Clinic, Seirei-Mikatabara General Hospital, Hamamatsu, Japan

,

Tomosue Takada

¹Staff Anesthesiologist, Department of Anesthesiology and Pain Clinic, Seirei-Mikatabara General Hospital, Hamamatsu, Japan

,

Shigehito Sato

²Professor and Chairman, Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, Hamamatsu, Japan

› Author Affiliations

Abstract

Summary

We investigated age- and sex-specific incidence, risk factors, and latency period of a perioperative acute thromboembolism syndrome (PATS) in a large cohort study. We prospectively analyzed data on 21903 consecutive surgery patients to determine the incidence of myocardial infarction, pulmonary embolism, deep venous thrombosis, stroke, and cardiovascular death within 30 postoperative days. Among 255 (1.2 percent) patients with thromboembolism, 105 (0.48 percent) suffered myocardial infarction (mean latency: 5 days), 30 (0.14 percent) suffered pulmonary embolism (6 days), 23 (0.11 percent) suffered deep venous thrombosis (10 days), 97 (0.44 percent) suffered stroke (11 days), and 13 (0.06 percent) died (12 days). The critical period was postoperative week 1 for myocardial infarction and pulmonary embolism, and postoperative week 1 and 2 for deep venous thrombosis, stroke, and death. Risk of all events increased with age (P<0.0001), particularly for over 70 years (odds ratio: 12.5; 95 percent confidence interval, 7.8 to 19.9). Males had an increased risk (P<0.0001) of myocardial infarction (odds ratio; 1.5; 95 percent confidence interval, 1.0 to 2.3). Females had an increased risk (P<0.0001) of pulmonary embolism (odds ratio: 2.7; 95 percent confidence interval, 1.3 to 5.9) and deep venous thrombosis (odds ratio: 9.8; 95 percent confidence interval, 3.3 to 29.3). Risk of thromboembolic event was higher (P<0.0001) in patients with a history of arterial thrombotic events or cancer. Trend analysis indicates that thromboembolic events will increase 3-fold over the next decade. Our findings enable identification of higher risk patients for prophylactic anti-thromboembolic treatment and awareness of the critical postoperative period.

Keywords

Myocardial infarction - pulmonary embolism - deep venous thrombosis - stroke - death

Full Text

References

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