Pulmonary Embolism Risk Elevated for More Than Six Weeks Postop

The postoperative risk for pulmonary embolism extends more than six weeks for six types of surgery, according to a study published online Oct. 9 in JAMA Surgery.

Alexandre Caron, M.D., from University Lille in France, and colleagues used data from a French national inpatient database (60,703 patients; 58.9 percent male; mean age, 56.6 years) between 2007 and 2014 to assess the duration of risk for pulmonary embolism following six types of surgery: vascular surgery, gynecological surgery, gastrointestinal surgery, hip or knee replacement, surgery for fractures, and other orthopedic operations.

The researchers found that the risk for postoperative pulmonary embolism was elevated for at least 12 weeks after all types of surgery and was highest during the immediate postoperative period (one to six weeks). The heightened risk for postoperative pulmonary embolism ranged from an odds ratio (OR) of 5.24 for vascular surgery to 8.34 for surgery for fractures. The risk remained higher for seven to 12 weeks, with the OR ranging from 2.26 for gastrointestinal operations to 4.23 for surgery for fractures. Beyond 18 weeks postsurgery, there was no clinically significant risk for any of the procedures.

“The persistence of this excess risk suggests that further randomized clinical trials are required to evaluate whether the duration of postoperative prophylactic anticoagulation should be extended and to define the optimal duration of treatment with regard to both the thrombotic and bleeding risks,” the authors write.

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