title: Does the presence of thyroid cancer increase the risk of venous thromboembolism in patients undergoing thyroidectomy?
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a leading cause of postoperative morbidity and mortality in cancer patients. We evaluate the association between thyroid cancer (TCA) and VTE in thyroidectomy patients and assess the impact of TCA status on risk level using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Best Practices guideline.
  
  
  METHODS
  A retrospective cohort study of thyroidectomy patients using the ACS NSQIP database (2005-2008) was performed. Patients were stratified by the presence (TCA) or absence (non-TCA) of TCA. The incidence of 30-day postoperative VTE and VTE risk factors were compared between groups. Risk factor scores (RFS) for VTE were computed with and without TCA as a factor.
  
  
  RESULTS
  Fifteen VTE events were documented in 19,640 patients. The incidence of VTE was 0.08% in the TCA and 0.07% in non-TCA groups (P = .783). TCA patients were younger, had a lower body mass index, and had longer operations than non-TCA patients. TCA patients had slightly higher RFS before inclusion of TCA (mean of 4.26 vs 4.16; P < .001). After adjustment for the RFS, TCA was not associated with an increased risk of VTE.
  
  
  CONCLUSIONS
  TCA does not seem to be independently associated with VTE in patients undergoing thyroidectomy. The decision for anticoagulation should therefore be determined by individual patient risk factors.
authors.affiliation: Department of Surgery, University of Pennsylvania School of Medicine, Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Reinke
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Hadler
authors.forename: Giorgos C
authors.initials: GC
authors.lastname: Karakousis
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Fraker
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Kelz
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013959:Thyroid Diseases / Q000150:complications / Q000601:surgery; D013964:Thyroid Neoplasms / Q000150:complications / Q000601:surgery*; D013965:Thyroidectomy; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology*