Incidence of postsurgical pulmonary embolism and deep venous thrombosis: a single-center retrospective observational study

Abstract

Abstract Background Cancer is a risk factor for perioperative deep venous thrombosis and pulmonary embolism (DVT/PE). However, there is a paucity of data on non-malignant digestive diseases. In this study, we aimed to investigate the incidence of DVT/PE among patients, following surgery for acute appendicitis and other digestive diseases. Methods We retrospectively reviewed the records of patients who underwent surgical procedures involving the digestive system between April 2018 and March 2019 attended by anesthesiologists (n = 536). Results DVT/PE developed in seven patients (7/77, 9.1%, 95% confidence interval [CI] 3.7–17.8%) after surgery for acute appendicitis, and in six patients (6/83, 7.2%, 95%CI 2.7–15.1%) after elective surgery for colorectal cancer. Among the acute appendicitis group, six patients (6/30 20.0%) with complicated appendicitis (gangrenous or perforated appendicitis), and one patient (1/47 2.1%) with simple appendicitis showed postoperative DVT/PE. Patients with complicated appendicitis had a higher risk of DVT/PE than those with simple appendicitis with an odds ratio of 11.5 (95%CI 1.3–101.1). Conclusions Although patients with acute appendicitis lack three of the risk factors for DVT/PE (cancer, long operative time, and older age), their 95% CI for the incidence of DVT/PE was comparable to that of patients undergoing elective surgery for colorectal cancer. Therefore, caution must be exercised during the perioperative period for preventing DVT/PE.

Keywords

• Deep venous thrombosis and pulmonary embolism
• Acute appendicitis
• Complicated appendicitis
• D-dimer
• Enhanced computed tomography scan