Systematic review and meta-analysis of venous thromboembolism in otolaryngology-head and neck surgery

Sami P Moubayed; Antoine Eskander; Moustafa W Mourad; Sam P Most

doi:10.1002/hed.24758

Systematic review and meta-analysis of venous thromboembolism in otolaryngology-head and neck surgery

Head Neck. 2017 Jun;39(6):1249-1258. doi: 10.1002/hed.24758. Epub 2017 Mar 29.

Authors

Sami P Moubayed¹, Antoine Eskander², Moustafa W Mourad³, Sam P Most¹

Affiliations

¹ Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Stanford, California.
² Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
³ Department of Otolaryngology - Head and Neck Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, New York.

PMID: 28370756
DOI: 10.1002/hed.24758

Abstract

Background: The purpose of this study was to present our systematic review and meta-analysis of the data on venous thromboembolism (VTE; deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) in otolaryngology-head and neck surgery (OHNS).

Methods: PubMed and Scopus databases were searched for studies reporting VTE in OHNS. Incidence of VTE and bleeding is reported and meta-analyzed overall and for chemoprophylaxis and squamous cell carcinoma (SCC)/free flap subgroups.

Results: A total of 23 studies were included with a total of 618,264 patients. Incidence of VTE was 0.4%. The incidence of bleeding complications was 0.9%. The addition of chemoprophylaxis did not result in a decreased VTE incidence (odds ratio [OR], 0.86), but produced an increased risk of bleeding (OR, 3.78). The overall OR for VTE in SCC/free flap cases was 6.28.

Conclusion: Chemoprophylaxis may not be necessary in the OHNS non-SCC or free flap patient population and must be balanced against an increased risk of bleeding. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1249-1258, 2017.

Keywords: otolaryngology; thromboembolic; thromboembolism; thromboprophylaxis; thrombosis.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Disease-Free Survival
Female
Head and Neck Neoplasms / mortality
Head and Neck Neoplasms / pathology
Head and Neck Neoplasms / surgery
Humans
Incidence
Male
Otorhinolaryngologic Diseases / pathology
Otorhinolaryngologic Diseases / surgery
Otorhinolaryngologic Neoplasms / diagnosis
Otorhinolaryngologic Neoplasms / surgery*
Otorhinolaryngologic Surgical Procedures / adverse effects*
Otorhinolaryngologic Surgical Procedures / methods
Postoperative Complications / mortality
Postoperative Complications / physiopathology
Prognosis
Pulmonary Embolism / epidemiology*
Pulmonary Embolism / etiology
Pulmonary Embolism / physiopathology
Risk Assessment
Survival Analysis
Venous Thromboembolism / epidemiology*
Venous Thromboembolism / etiology
Venous Thromboembolism / physiopathology