Preexisting morbidity as an independent risk factor for perioperative acute thromboembolism syndrome.
OBJECTIVE
Preexisting morbidities are risk factors for perioperative arterial or venous thromboembolic events and subsequent death within 30 postoperative days.


METHODS
Prospective cohort study.


METHODS
University-affiliated general hospital.


METHODS
A total of 21,903 surgery patients treated from January 1, 1991, through December 31, 2002.


METHODS
Independent risk factors for perioperative arterial or venous thromboembolic events.


RESULTS
History of atrial fibrillation and coronary artery disease increased the risk of myocardial infarction (odds ratio [95% confidence interval], 4.3 [2.8-6.7]). History of stroke increased the risk of stroke (2.4 [1.4-4.1]) and death (4.7 [1.3-17.3]). Diabetes mellitus increased the risk of myocardial infarction (2.1 [1.3-3.2]), and hyperuricemia increased the risk of stroke (3.5 [1.2-9.8]), and both increased the risk of death (4.3 [1.3-14.1] and 11.8 [2.2-63.5], respectively). History of myocardial infarction increased the risk of deep vein thrombosis (7.7 [1.7-34.7]). Cancer increased the risk of all thromboembolism (2.4 [1.9-3.2]). Trend analysis showed that preexisting morbidities will increase 1.5-fold and thromboembolic events will increase 3-fold during the next decade.


CONCLUSIONS
Cardiac and cerebrovascular diseases, metabolic diseases, and cancer are becoming increasingly high-risk comorbidities for perioperative acute thromboembolism syndrome.
Kikura
Mutsuhito
M
Department of Anesthesiology and Pain Clinic, Seirei-Mikatabara General Hospital, Hamamatsu, Japan. mkikura@hotmail.com
Takada
Tomosue
T
Sato
Shigehito
S
D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology; D013577:Syndrome; D013923:Thromboembolism / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality