학술논문

Prolonged operating room time in emergency general surgery is associated with venous thromboembolic complications
Document Type
Report
Source
The American Journal of Surgery. Nov 2019, Vol. 218 Issue 5, 836
Subject
Complications and side effects
Pulmonary embolism -- Complications and side effects
Thromboembolism -- Complications and side effects
Surgery
Language
English
ISSN
0002-9610
Abstract
Keywords Emergency general surgery; Venous thromboembolism; Prolonged operative time; Deep venous thrombosis; Pulmonary embolism Highlights * Operating time of [greater than or equal to]100 min is associated with increased risk of developing a VTE. * Every 10 min thereafter increases the risk of developing a DVT by 7% and PE by 5%. * Other independent predictors of VTE complications were older age and history of cancer. * Emergent colectomies were associated with the highest odds for both DVT and PE. Abstract Background We evaluated the association between operating room time and developing a deep vein thrombosis (DVT) or pulmonary embolus (PE) after emergency general surgery (EGS). Methods We reviewed six common EGS procedures in the 2013--2015 NSQIP dataset. After tabulating their incidence of postoperative VTE events, we calculated predictors of developing a VTE using adjusted multivariate logistic regressions. Results Of 108,954 EGS patients, 1,366 patients (1.3%) developed a VTE postoperatively. The median time to diagnosis was 9 days [5--16] for DVTs and 8 days [5--16] for PEs. Operating room time of 100 min or more was associated with increased risk of developing a DVT (OR 1.30 [1.12--2.21]) and PE (OR:1.25 [1.11--2.43]) with a 7% and 5% respective increase for every 10 min increase after the 100 min. Other independent predictors of VTE complications were older age, and history of cancer, and emergent colectomies on procedure-level analysis. Conclusion Prolonged operating room time is independently associated with increased risk of developing VTE complications after an EGS procedure. Most of the VTE complications were delayed in presentation.