A retrospective study on pulmonary embolism incidence and thromboprophylaxis after thoracic surgery among 1 500 patients / 中华胸心血管外科杂志

ABSTRACT

Objective:To evaluate the inpatient PE incidence and thromboprophylaxis after thoracic surgery according to adjusted Caprini VTE risk assessment model.Methods:The study selected consecutively 500 patients who received thoracic surgery from first of June in consecutive three years of 2015, 2016 and 2017. We retrospectively assessed these 1 500 patients using Caprini VTE risk model and recorded baseline characteristics, postoperative prophylaxis, and PE incidence.Results:Only 19.4% of 2015-year patients received pharmacologic prophylaxis, while the rate reached up to 65.2% in 2016 and 77.2% in 2017. PE occurred on 4 cases in 2015, 1 case in 2016, and 0 case in 2017. The overall incidence of PE was 0.3%(5/1 500). The PE incidence negatively correlated with the implementation of prophylaxis( r=-0.04, P=0.07). The PE risk(odds ratio) increased 4.68 times(95% CI 0.525-41.800) when patients did not receive prophylaxis in PE cohort. Postoperative pharmacologic prophylaxis with current dosing did not affect the drainage of chest tube after surgery. Conclusion:Implementation of an adjusted Caprini risk assessment protocol can be useful for the thoracic postoperative patients to receive appropriate thromboprophylaxis. Current pharmacologic prophylaxis protocol should be safe and enough to prevent PE after thoracic surgery.