Venous thromboembolism in body contouring: an analysis of 17,774 patients from the National Surgical Quality Improvement databases.

Abstract

BACKGROUND:

The purpose of this study was to examine the incidence and predictors of venous thromboembolism following body contouring.

METHODS:

The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2012 for all body contouring cases. A multivariate logistic regression was performed to determine predictors of venous thromboembolism, and used to define risk scores for each significant predictor.

RESULTS:

Seventeen thousand seven hundred seventy-four patients underwent body contouring during the study period. Venous thromboembolism occurred in 99 individuals (0.56 percent). Multivariate logistic regression revealed that age older than 45 years [45 to 60 years (OR, 1.54; p = 0.1); older than 60 years (OR 3.1, p < 0.001)], undergoing contouring of the trunk (OR, 2.75; p < 0.001), obesity [body mass index of 30 to 34.9 (OR, 3.35; p < 0.001); body mass index of 35 to 39.9 (OR, 4.41; p < 0.001); body mass index ≥ 40 (OR, 3.14; p = 0.001)], and admission on an inpatient basis (OR, 3.01; p < 0.001) were associated with increased odds of venous thromboembolism. Patients' total scores were categorized as low (0 to 4), medium (5 to 7), or high risk (8 to 9). The low-risk cohort exhibited a venous thromboembolism incidence of 0.14 percent, the medium-risk cohort experienced an incidence of 0.97 percent, and the high-risk group experienced a venous thromboembolism incidence of 2.95 percent.

CONCLUSIONS:

This study identifies predictors of venous thromboembolism and creates a simple risk-scoring model using a large, prospective data set. The authors' analysis demonstrates that in the presence of certain risk factors, the incidence of venous thromboembolism increases dramatically; in these cases, venous thromboembolism prophylaxis may be warranted.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.

• Authors: Ari M Wes, Jason D Wink, Stephen J Kovach, John P Fischer
• Journal: Plastic and reconstructive surgery (Plast Reconstr Surg) Vol. 135 Issue 6 Pg. 972e-980e (Jun 2015) ISSN: 1529-4242 [Electronic] United States
• PMID: 26017613 (Publication Type: Comparative Study, Journal Article)

Topics

• Age Distribution
• Aged
• Body Mass Index
• Databases, Factual
• Female
• Humans
• Lipectomy (adverse effects, methods)
• Logistic Models
• Middle Aged
• Multivariate Analysis
• Obesity, Morbid (diagnosis, surgery)
• Odds Ratio
• Postoperative Complications (epidemiology, physiopathology)
• Predictive Value of Tests
• Prognosis
• Quality Improvement
• Retrospective Studies
• Risk Assessment
• Sex Distribution
• Surgery, Plastic (adverse effects, methods)
• Thromboembolism (epidemiology, etiology, physiopathology)
• Treatment Outcome
• United States
• Venous Thrombosis (epidemiology, etiology, physiopathology)