Pulmonary embolism: specific risk factor after pancreas resection?
OBJECTIVE
Pulmonary embolism (PE) after major abdominal surgery is a serious and potentially lethal complication. The purpose of the present study was to identify risk factors for postoperative PE after pancreas resection.


METHODS
Our prospective database for pancreatic surgery was retrospectively analyzed for patients treated between January 2006 and August 2012 in a tertiary care Swiss hospital. Risk factors for PE were identified in univariate and multivariate analyses that included preoperative, intraoperative, and postoperative variables.


RESULTS
Among 251 patients, 187 underwent pancreato-duodenectomy (PD), 62 underwent distal pancreatectomy, and 2 underwent other types of pancreas resections. PE was diagnosed in 13 patients (7.0%) after PD and none after other procedures. Compared with the non-PE group, the PE group had higher body mass indices (≥25 kg/m, P = 0.04), longer median operation times (P = 0.009), higher rates of severe abdominal complications (P < 0.001), longer median intensive care unit stays (P = 0.003), and longer hospital stays (P = 0.01). Multivariate analyses identified the following independent predictors for PE: a history of thromboembolic events (odds ratio [OR], 22.3), prolonged operation time (OR, 5.76), and major abdominal complications (OR, 10.8).


CONCLUSIONS
Prolonged operation times and major postoperative abdominal complications were strong risk factors for PE after PD, in both univariate and multivariate analyses.
From the Department of Visceral Surgery, University Hospital Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Takashi
T
Kokudo
Emilie
E
Uldry
Nicolas
N
Demartines
Nermin
N
Halkic
D000368:Aged; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data