Venous thromboembolism in body contouring: an analysis of 17,774 patients from the National Surgical Quality Improvement databases.

BACKGROUND The purpose of this study was to examine the incidence and predictors of venous thromboembolism following body contouring. METHODS The authors reviewed the American College of Surgeons National Surgical Quality Improvement Program database from 2005 to 2012 for all body contouring cases. A multivariate logistic regression was performed to determine predictors of venous thromboembolism, and used to define risk scores for each significant predictor. RESULTS Seventeen thousand seven hundred seventy-four patients underwent body contouring during the study period. Venous thromboembolism occurred in 99 individuals (0.56 percent). Multivariate logistic regression revealed that age older than 45 years [45 to 60 years (OR, 1.54; p = 0.1); older than 60 years (OR 3.1, p < 0.001)], undergoing contouring of the trunk (OR, 2.75; p < 0.001), obesity [body mass index of 30 to 34.9 (OR, 3.35; p < 0.001); body mass index of 35 to 39.9 (OR, 4.41; p < 0.001); body mass index ≥ 40 (OR, 3.14; p = 0.001)], and admission on an inpatient basis (OR, 3.01; p < 0.001) were associated with increased odds of venous thromboembolism. Patients' total scores were categorized as low (0 to 4), medium (5 to 7), or high risk (8 to 9). The low-risk cohort exhibited a venous thromboembolism incidence of 0.14 percent, the medium-risk cohort experienced an incidence of 0.97 percent, and the high-risk group experienced a venous thromboembolism incidence of 2.95 percent. CONCLUSIONS This study identifies predictors of venous thromboembolism and creates a simple risk-scoring model using a large, prospective data set. The authors' analysis demonstrates that in the presence of certain risk factors, the incidence of venous thromboembolism increases dramatically; in these cases, venous thromboembolism prophylaxis may be warranted. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.