Abstract 15165: Clinical Characteristics and Outcome of Venous Thromboembolism in Patients After Surgical Procedure: From the COMMAND VTE Registry-2

Abstract

Background: Undergoing surgical procedure is a risk factor for venous thromboembolism (VTE). However, the prognosis of VTE in patients after surgical procedure has not been fully evaluated in the Era of direct oral anticoagulant (DOAC). We elucidated the prognosis of VTE in patients who have undergone surgical procedure. Methods: The COMMAND VTE Registry-2 is a multicenter registry enrolling 5197 consecutive acute symptomatic VTE patients among 31 centers in Japan between January 2015 and August 2020. According to the history of surgical procedure within 2 months, we divided the study patients into 2 groups; Surgical group (N=793) and Non-surgical group (N=4404). Clinical outcome including all-cause death and recurrence of VTE was compared between the two groups. Results: There were more women in surgical group than non-surgical group (64% vs. 58%, P<0.01). In addition, surgical group had higher prevalence of active cancer (34% vs. 28%, P<0.01), and lower prevalence of kidney disease (16% vs. 20%, P<0.01) than non-surgical group. The cumulative incidences of all-cause death and recurrent VTE at 2-year were significantly lower in surgical group than non-surgical group (all-cause death: 16.6±1.4% vs. 24.4±0.7%, P<0.01; recurrent VTE: 2.8±0.7% vs. 5.7±0.4%, P<0.01, respectively). In surgical group, Cox regression analysis identified diabetes mellitus as the independent risk factor for recurrence of VTE (hazard ratio 2.90; 95% confidence interval, 1.24-6.74; P=0.01). Conclusion: Patients after surgical procedure had lower mortality and incidence of recurrent VTE than non-surgical group. Diabetes mellitus is the independent risk factor for recurrence of VTE in patients after surgical procedure.