Readmission rates due to venous thromboembolism in cancer patients after abdominopelvic surgery, a retrospective chart review.

Abstract

Venous thromboembolism (VTE) is a known cause of morbidity in the oncology patient population. As hospital readmission rates are more frequently scrutinized, we sought to determine the most common causes of 30-day readmissions in the cancer patient following abdominopelvic surgery. Furthermore, due to the high risk of VTE, there have been guidelines established for prophylaxis. As guidelines are based on asymptomatic VTE, we studied the compliance rates of these guidelines in our institution and the rate of symptomatic VTE in the 30-day postoperative period. We conducted a retrospective chart review at Pennsylvania Hospital of abdominopelvic surgeries between January 1, 2010 and December 31, 2012 in patients with abdominopelvic malignancies, totaling 263 patients. The median age of our patient population was 67 years and 51.3 % were female. The most common malignancy locations were colorectal (44 %) and pancreas (11 %). One patient did not receive perioperative anticoagulation; most received heparin subcutaneously three times daily, mean duration 5.5 days. Fourteen patients (5 %) received outpatient anticoagulation after discharge; only two had a primary intent of VTE prophylaxis. Thirty-five patients (13 %) were readmitted within 30 days of discharge, the most common reasons being abdominal symptoms and postoperative/surgical complications. There was one patient readmitted for a new, symptomatic VTE. Our study showed only one new, symptomatic VTE in the study population, despite 95 % of patients not receiving outpatient anticoagulation, which suggests that continued larger and multicenter trials may be needed to study anticoagulation benefits and risks in this patient population.