Perioperative risk factors for death among patients with symptomatic pulmonary thromboembolism

Abstract

Perioperative pulmonary thromboembolism (PTE) is a fatal complication that may occur in patients who are undergoing surgery. This study aimed to identify risk factors for PTE-related death. This study evaluated data for the most recent 5-year period (2007–2011) from the Japanese Society of Anesthesiologists' database of patients who experienced perioperative PTE. We compared patients who died within 30 days of onset and patients who survived for > 30 days, and used logistic regression analysis to identify the independent risk factors. We identified 1894 patients who experienced PTE; 294 patients died within 30 days and 1600 patients survived for > 30 days. Univariate analyses revealed that PTE-related death was significantly associated with male sex, an age of ≥ 80 years, bedridden status, and trauma or heart failure. Survival was significantly associated with the use of anticoagulant therapy, obesity, and a recent history of venous thromboembolism. Logistic regression analyses revealed that male sex, an age of ≥ 80 years, bedridden status, heart failure, and the non-use of anticoagulant therapy were independent risk factors for PTE-related death. We found that male sex, an age of ≥ 80 years, bedridden status, heart failure, and the non-use of anticoagulant therapy were independent risk factors for perioperative PTE-related death. Therefore, appropriate interventions for bedridden patients and thromboprophylaxis using anticoagulants may help reduce the incidence of perioperative PTE-related mortality.

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