title: Incidence of, and risk factors for, postoperative venous thromboembolism in patients with benign or malignant musculoskeletal tumors.
abstract: BACKGROUND
  Venous thromboembolism is a serious complication after surgery for malignant musculoskeletal tumors in the lower extremity. However, the incidence of postoperative venous thromboembolism in patients with benign musculoskeletal tumors and musculoskeletal tumors in the upper extremity or trunk remains unclear. Identifying risk factors may provide useful information for selecting patients who should receive chemoprophylaxis.
  
  
  METHODS
  A retrospective study of 833 patients with musculoskeletal tumors who underwent surgery was conducted. Patients were divided into four groups: 364 patients with benign tumors in the upper extremity or trunk (group 1); 315 patients with benign tumors in the lower extremity or pelvis (group 2); 50 patients with malignant tumors in the upper extremity or trunk (group 3); and 104 patients with malignant tumors in the lower extremity or pelvis (group 4). The incidence of venous thromboembolism was investigated, and risk factors were examined for group 4.
  
  
  RESULTS
  The incidence of postoperative venous thromboembolism was 0, 0.95, 0, and 4.8 % in groups 1, 2, 3, and 4, respectively. The incidence of venous thromboembolism in the malignant tumor group (groups 3 + group 4) was significantly higher than that in the benign tumor group (group 1 + group 2). The incidence of postoperative venous thromboembolism in the upper extremity or trunk group (group 1 + group 3) was significantly lower than that in the lower extremity or pelvis group (group 2 + group 4). In group 4, a higher incidence of postoperative venous thromboembolism was significantly correlated with a history of cerebrovascular disease and surgery in the prone position.
  
  
  CONCLUSIONS
  Patients with malignant tumors in the lower extremity or pelvis, particularly those with a history of cerebrovascular disease and surgery in a prone position, were at high risk of venous thromboembolism. Patients with benign tumors in the lower extremity or pelvis were at intermediate risk. This is important information for predicting the incidence of postoperative venous thromboembolism and determining who should receive chemoprophylaxis after surgery for musculoskeletal tumors.
authors.affiliation: Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Hon-Komagome, Bunkyo-ku, Tokyo 113-8677, Japan. ytsuda-tuk@umin.ac.jp
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tsuda
authors.forename: Takahiro
authors.initials: T
authors.lastname: Goto
authors.forename: Masachika
authors.initials: M
authors.lastname: Ikegami
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamada
authors.forename: Kiyofumi
authors.initials: K
authors.lastname: Yamakawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Hozumi
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kawano
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Takaki
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kitahara
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology*