SSAT - EFFECTS OF POST-DISCHARGE VENOUS THROMBOEMBOLISM AFTER HEPATOPANCREATICOBILIARY OPERATIONS

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EFFECTS OF POST-DISCHARGE VENOUS THROMBOEMBOLISM AFTER HEPATOPANCREATICOBILIARY OPERATIONS
Nkiruka Arinze^*¹, Gregory Patts², Angela Kuhnen¹, George Kasotakis¹, Jeffrey Siracuse¹, Jennifer Tseng¹, David McAneny¹, Teviah Sachs¹
¹General Surgery, Boston University School of Medicine, Boston, MA; ²Data Coordinating Center, Boston University School of Public Health, Boston, MA

Background: Venous thromboembolism (VTE) can be a devastating complication associated with increased readmissions, morbidity and mortality. It is particularly important in patients undergoing hepatobiliary and pancreatic operations, as they have increased risk of VTE. Our study sought to determine the incidence of post-discharge VTE in patients undergoing pancreatic and hepatobiliary resections, and its influence on outcomes.

Methods: This retrospective analysis used claims data from a comprehensive, longitudinal dataset with de-identified claims from privately insured and Medicare Advantage enrollees to analyze the rates of 30-day and 90-day VTE, 30 and 90-day readmissions, 30-day reoperation, and 30-day wound infection.

Results: 6,628 patients were identified, with an overall rate of VTE at 30 days of 2.5% and at 90 days of 5.8%. Only VTE at 30 days was associated with 11-fold increased risk of readmission at 30 days (OR 11.17, CI 7.79-16, p<.0001). VTE at 90 days was associated with 6-fold increased risk of readmission at 90 days (OR 6.41, CI 5.03-8.17, p<.0001).

Discussion: Rates of post-discharge VTE are high in patients undergoing pancreatic and hepatobiliary resections and show a strong relationship with readmissions, highlighting the importance of instituting protocols and extended prophylaxis for the prevention of VTE in this high-risk population.

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