Preinduction and Postdischarge Venothromboembolism Chemoprophylaxis Should Be Considered in Patients After Vascular Major Open Abdominal Procedures

Venous thromboembolism (VTE) is a significant morbidity following open major abdominal surgery. Whereas there clear guidance for preinduction VTE prophylaxis in general surgery population, none the vascular population because of belief that intraoperative therapeutic heparin should prevent VTE. Although most patients receive while hospital, postdischarge common practice. We investigate incidence after compared to cases, particularly pattern in-hospital and determine whether current practice be adjusted. Two populations were American College Surgeons National Surgical Quality Improvement Program database from 2011 2021: general. Vascular cases identified using targeted aortic aneurysm aortoiliac disease Current Procedural Terminology codes enterectomy, gastrectomy, colectomy, hepatectomy, pancreatectomy, nephrectomy. There preoperative differences between two groups which we accounted 1:1 propensity matching. The 30-day outcomes studied. After matching, 13,093 13,196 was no difference mortality, adverse cardiac events, pulmonary complications, renal sepsis, or length stay. rate significantly lower (1.31% vs. 3.02%; adjusted odds ratio [aOR], 0.4266; P < .0001). In with associated higher mortality (aOR, 0.5888; = .0283), events 0.4360; .0001), complications 0.2058; dysfunction 0.5501; .02), sepsis 0.2523; stay >7 days 0.256; Mean time operating room occurrence 10.52 ± 7.14 days. showed bimodal distribution 77% occurring early period (<14 days) 23% late (>14 (Figure). Seventy-eight percent developed 22% discharge. cases; however, 1.31% still number given VTE, strongly considered. majority occurred cohort develop postoperative developing post-discharge, suggesting considered selective high-risk patients.