Volume 15, Issue 1 (2026)
WJPS 2026, 15(1): 62-70 |
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1- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States , Hossein.Masoomi@kp.org
2- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States
3- Division of Plastic and Reconstructive Surgery, University of Texas, Health Science Center at Houston
2- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States
3- Division of Plastic and Reconstructive Surgery, University of Texas, Health Science Center at Houston
Abstract: (835 Views)
Background: Venous thromboembolism (VTE) is one of the known medical complications in autologous breast reconstruction (ABR) which is associated
with a short and long-term morbidity as well as mortality. Identifying VTE risk factors is crucial for appropriate VTE prophylaxis measurements to
lower this complication following ABR.
Methods: Using American College of Surgeons National Surgery Quality Improvement Project database, we examined the clinical data of patients
who underwent ABR from 2016-2020 in the US. The frequency of VTE, day of occurrences and risk factors associated with VTE were evaluated.
Results: Overall, 11,847 patients underwent ABR in the study period. The overall VTE rate was 1.0%. Totally 117 patients experienced VTE with a
total occurrence of 127. Postoperative day 1 and 2 were reported with the highest frequency of VTE (21/127). Using multivariate regression analysis,
independent risk factors associated with a higher VTE rate were length of hospital stay>=5 d [adjusted odd’s ratio (AOR), 3.29], operative time
longer than 10 h (AOR,2.17), and immediate reconstruction (AOR,1.51). Although free flap breast reconstruction was associate with a higher VTE
rate compared with pedicled flap reconstruction (1.2% vs. 0.8%); however, multivariate regressing analysis did not show this factor as an independent
VTE risk factor.
Conclusion: Being proactive to make the patients ready to discharge by POD-4 and having strategy to shorten the length of operation could help to
lower the rate of VTE in ABR. Plastic surgeons should consider these factors and use appropriate prophylactic measures to minimize the risk of VTE
development.
with a short and long-term morbidity as well as mortality. Identifying VTE risk factors is crucial for appropriate VTE prophylaxis measurements to
lower this complication following ABR.
Methods: Using American College of Surgeons National Surgery Quality Improvement Project database, we examined the clinical data of patients
who underwent ABR from 2016-2020 in the US. The frequency of VTE, day of occurrences and risk factors associated with VTE were evaluated.
Results: Overall, 11,847 patients underwent ABR in the study period. The overall VTE rate was 1.0%. Totally 117 patients experienced VTE with a
total occurrence of 127. Postoperative day 1 and 2 were reported with the highest frequency of VTE (21/127). Using multivariate regression analysis,
independent risk factors associated with a higher VTE rate were length of hospital stay>=5 d [adjusted odd’s ratio (AOR), 3.29], operative time
longer than 10 h (AOR,2.17), and immediate reconstruction (AOR,1.51). Although free flap breast reconstruction was associate with a higher VTE
rate compared with pedicled flap reconstruction (1.2% vs. 0.8%); however, multivariate regressing analysis did not show this factor as an independent
VTE risk factor.
Conclusion: Being proactive to make the patients ready to discharge by POD-4 and having strategy to shorten the length of operation could help to
lower the rate of VTE in ABR. Plastic surgeons should consider these factors and use appropriate prophylactic measures to minimize the risk of VTE
development.
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