Perioperative risk factors for death among patients with symptomatic pulmonary thromboembolism.

Abstract

Perioperative pulmonary thromboembolism (PTE) is a fatal complication that may occur in patients who are undergoing surgery. This study aimed to identify risk factors for PTE-related death. This study evaluated data for the most recent 5-year period (2007-2011) from the Japanese Society of Anesthesiologists' database of patients who experienced perioperative PTE. We compared patients who died within 30days of onset and patients who survived for >30days, and used logistic regression analysis to identify the independent risk factors. We identified 1894 patients who experienced PTE; 294 patients died within 30days and 1600 patients survived for >30days. Univariate analyses revealed that PTE-related death was significantly associated with male sex, an age of ≥80years, bedridden status, and trauma or heart failure. Survival was significantly associated with the use of anticoagulant therapy, obesity, and a recent history of venous thromboembolism. Logistic regression analyses revealed that male sex, an age of ≥80years, bedridden status, heart failure, and the non-use of anticoagulant therapy were independent risk factors for PTE-related death. We found that male sex, an age of ≥80years, bedridden status, heart failure, and the non-use of anticoagulant therapy were independent risk factors for perioperative PTE-related death. Therefore, appropriate interventions for bedridden patients and thromboprophylaxis using anticoagulants may help reduce the incidence of perioperative PTE-related mortality.