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Association of Surgical and Medical Hospitalizations with Venous Thromboembolism (VTE) in a Primary Care Population

1University of Vermont Medical Center, Hematology and Oncology, Burlington, United States, 2University of Vermont, Burlington, United States, 3University of Vermont Medical Center, Burlington, United States, 4University of Vermont, Hematology Oncology, Burlington, United States, 5Hennepin Research Institute, Minneapolis, United States, 6University of Minnesota, Mineapolis, United States, 7University of Vermont, Internal Medicine, Burlington, United States, 8University of Vermont, Thrombosis and Hemostasis Program, Burlington, United States, 9University of Vermont, Hematology, Burlington, United States

Abstract Number: PB2333

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » VTE Epidemiology

Background: Yearly one million U.S. individuals will be diagnosed with VTE, ~30% occurring during or within 3 months of hospitalization. The absolute and relative rates of VTE during and post hospitalization are not well studied.

Aims: Identify the relative and absolute risks of VTE for during and after medical and surgical hospitalizations.

Methods: Structured electronic health record data identified hospitalizations and VTE events for patients aged ≥18 years receiving their care within an academic health network between 2010 and 2016. We defined VTE using 1 inpatient or 2 outpatient VTE codes 7-180 days apart in addition to anticoagulant use within 30 days. We censored at the first VTE event. Cox models compared risk of a VTE during and following hospitalization relative to the rate among those without a current hospitalization or hospitalization in the prior 3 months, adjusted for age and sex and stratified by medical versus surgical hospitalization.

Results: From 2010-16, 87,821 patients contributed to 371,429 person-years of follow-up and 749 VTE. Of these, 21,963 patients were hospitalized 57,837 times (13,250 surgical admissions). Relative outpatients with no hospitalization in prior 3 months, the age and sex adjusted hazard ratio for VTE was 37.9 and 46.1 during medical and surgical hospitalizations respectively (Table). This comparison was 16.8 and 22.8 for the first month post discharge, 6.0 for both in the second month, and 5.0 and 4.9 in the third month post-discharge.

Conclusions: Medical and surgical hospitalizations were associated with a similarly increased risk of hospital acquired and post-discharge VTE. While we did not assess for procedures done during hospitalization, these data challenge the dogma that surgical hospitalizations are higher risk than medical hospitalizations for VTE and require further study as to who (if anyone) may benefit VTE prophylaxis inpatient or after discharge.


[Table]

To cite this abstract in AMA style:

Jordan Bruno X, Koh I, Plante TB, Holmes CE, Walker R, Lutsey P, Repp AB, Cushman M, Zakai NA. Association of Surgical and Medical Hospitalizations with Venous Thromboembolism (VTE) in a Primary Care Population [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/association-of-surgical-and-medical-hospitalizations-with-venous-thromboembolism-vte-in-a-primary-care-population/. Accessed October 1, 2023.

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