Venous thromboembolism in head and neck surgery: Risk, outcome, and burden at the national level

Head Neck. 2019 Feb;41(2):411-422. doi: 10.1002/hed.25409. Epub 2018 Dec 7.

Abstract

Background: Venous thromboembolism (VTE) can complicate major surgeries. This study examines the risk and outcomes of VTE in patients who underwent head and neck surgeries.

Methods: Retrospective cross-sectional analysis utilizing the Nationwide Readmissions Database (2010-2014). Study population included adults (≥18 year) patients who underwent head and neck surgeries.

Results: A total 386 VTE patients and 116 450 controls included. VTE risk was 0.37%, postoperative mortality was 4.87%. Of VTE, 57.02% identified within the initial admission for surgery, while the rest required readmission within 90 days. VTE high-risk surgeries included: major ear/skull base surgeries, major nose/paranasal sinuses surgeries, major mouth/tonsil surgeries, major salivary glands/ducts surgeries, major maxillofacial bones/mandible surgeries, and major and nonmajor pharynx and larynx surgeries (P < .05). Those same surgeries were also associated with a high risk of readmission (P < .05).

Conclusions: VTE is associated with a significant mortality risk. Surgeries that involve the pharynx and larynx have the highest risk of VTE and readmission.

Keywords: deep venous thrombosis; head and neck surgery; health services cost; length of stay; mortality risk; otolaryngology; outcome; prevalence; pulmonary embolism; venous thromboembolism.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged
  • Oral Surgical Procedures / adverse effects*
  • Otorhinolaryngologic Surgical Procedures / adverse effects*
  • Patient Readmission
  • Postoperative Complications / epidemiology*
  • Pulmonary Embolism / epidemiology*
  • Retrospective Studies
  • United States
  • Venous Thromboembolism / epidemiology*
  • Young Adult