title: Venous thromboembolism in reconstructive pelvic surgery.
abstract: OBJECTIVE
  We sought to determine the incidence and risk factors for venous thromboembolism (VTE) in women undergoing reconstructive pelvic surgery (RPS).
  
  
  METHODS
  Using the American College of Surgeons National Surgical Quality Improvement Program registry, we identified patients who underwent RPS from 2006 through 2010 based on Current Procedural Terminology codes. We defined 2 cohorts: women with any RPS performed, with concomitant surgery from other specialties allowed (RPS + other), and women whose only procedure was RPS. VTE was defined as deep vein thrombosis or pulmonary embolism diagnosed within 30 days of surgery. Demographic characteristics, comorbidities, and operative characteristics were extracted from the database. Variables were analyzed using χ(2) tests and Student t tests for categorical and continuous variables. We performed a multiple logistic regression to control for confounding variables.
  
  
  RESULTS
  In all, 20,687 women underwent RPS + other, with 69 cases of VTE for a rate of 0.3%. Multivariate analysis demonstrated predictors for postoperative VTE including inpatient hospital status (odds ratio [OR], 7.69; P < .001), higher American Society of Anesthesiology Physical Status classification (OR, 2.70; P < .001), and emergency intervention (OR, 3.65; P = .008). When women undergoing only RPS were analyzed, there were 14 cases of VTE, with an incidence of 0.1% and the only specific predictor for postoperative VTE was length of stay (P < .037).
  
  
  CONCLUSIONS
  The incidence of VTE following RPS is very low, but it is increased in women undergoing concomitant surgeries. Patients undergoing inpatient surgery with higher American Society of Anesthesiology Physical Status classifications and requiring emergency intervention were at highest risk for VTE.
authors: Division of Female Pelvic Medicine and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: mmueller@nmff.org.
authors: Margaret G
authors: MG
authors: Mueller
authors: Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors: Matthew A
authors: MA
authors: Pilecki
authors: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors: Tatiana
authors: T
authors: Catanzarite
authors: Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors: Umang
authors: U
authors: Jain
authors: Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors: John Y S
authors: JY
authors: Kim
authors: Division of Female Pelvic Medicine and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors: Kimberly
authors: K
authors: Kenton
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007044:Hysterectomy; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D061646:Operative Time; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011655:Pulmonary Embolism / Q000453:epidemiology*; D020047:Rectocele / Q000601:surgery*; D012307:Risk Factors; D053825:Suburethral Slings; D014549:Urinary Incontinence / Q000601:surgery*; D014596:Uterine Prolapse / Q000601:surgery; D014621:Vagina / Q000601:surgery*; D020246:Venous Thrombosis / Q000453:epidemiology*
keywords: deep vein thrombosis; pelvic reconstructive surgery; pulmonary embolism; venous thromboembolic event