Should all patients receive the same prophylaxis? Racial variation in the risk of venous thromboembolism after major abdominal operations - 29/11/21
, Zhi Ven Fong a, b , Motaz Qadan a , Hiroko Kunitake a , John T. Mullen a , David C. Chang a, b, ⁎ Abstract |
Background |
Whether prevention strategy for postoperative venous thromboembolism (VTE) should be tailored across racial groups remains unknown.
Methods |
Patients who underwent major abdominal operation in the Nationwide Inpatient Sample (NIS) were examined. Our primary outcome was postoperative VTE, and the secondary outcome was postoperative bleeding. Multivariable logistic regression analyses were performed and validated with the National Surgical Quality Improvement Program (NSQIP) database.
Results |
781,888 patients from NIS were analyzed. Overall VTE rate was 2.0%. Compared to White patients, Hispanic (OR 0.85, 95% CI 0.78–0.93, p < 0.01) and Asian patients (OR 0.49, 95% CI 0.40–0.61, p < 0.01) had significantly lower risks for VTE. In contrast, Asian patients had a significantly higher risk of bleeding (OR 1.39, 95% CI 1.24–1.56, p < 0.01). Similar trends were observed in NSQIP.
Conclusions |
The risk-benefit ratio of postoperative VTE prophylaxis for Asian patients is roughly three times higher than that for White patients, suggesting a tailored approach is necessary.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | Hispanic and Asian patients have a lower risk of postoperative venous thromboembolism. |
• | Asian patients have a higher risk of postoperative bleeding. |
• | The risk-benefit ratio of prophylaxis for Asian patients is roughly three times higher than that for White patients. |
• | Tailored approach to postoperative venous thromboembolism prophylaxis is necessary. |
Keywords : Tailored thromboembolism prophylaxis, Heterogeneity of treatment effect, Race and personalized medicine
Mappa
Vol 222 - N° 5
P. 884-889 - novembre 2021 Ritorno al numero
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