Risk factors of venous thromboembolism in patients with benign and malignant musculoskeletal tumors: a dual database ana
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ORIGINAL PAPER
Risk factors of venous thromboembolism in patients with benign and malignant musculoskeletal tumors: a dual database analysis Dominick V. Congiusta 1 Joseph Benevenia 1
&
Kamil M. Amer 1 & Jennifer Thomson 1 & Joseph Ippolito 1 & Kathleen S. Beebe 1 &
Received: 1 March 2020 / Accepted: 3 July 2020 # SICOT aisbl 2020
Abstract Purpose Venous thromboembolism (VTE) is a potentially life-threatening condition associated with both orthopaedic surgery and tumour growth. In this study, we identify risk factors associated with VTE in patients with musculoskeletal tumours using two national datasets. Methods The ACS-NSQIP and NIS databases were queried for patients undergoing surgery with a diagnosis of benign or malignant musculoskeletal tumours. Chi-square and binary logistic regression analyses were used to determine risk factors for VTE. Results The incidence of VTE was 2% in both databases. Patients with malignant tumours, those with tumours of the pelvis, sacrum, or coccyx, obesity, arrhythmias, paralysis, metastatic disease, coagulopathy, and recent weight loss were at increased risk for VTE. In patients with benign tumours, those who were African American, those with tumours of the pelvis, sacrum, or coccyx, diabetes, anaemia, and coagulopathy were at increased risk of VTE. Conclusions Patients with malignant or benign lesion are at greater risk of VTE if they are age 30 and over, of the African American population, or with tumors of the pelvis/sacrum/coccyx, or any of the following comorbidities: pulmonary disease, paralysis, other neurological disorders, or coagulopathy. Keywords Venous thromboembolism . Tumor . NIS . NSQIP
Introduction
* Dominick V. Congiusta [email protected] Kamil M. Amer [email protected] Jennifer Thomson [email protected] Joseph Ippolito [email protected] Kathleen S. Beebe [email protected] Joseph Benevenia [email protected] 1
Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, ACC D1610, Newark, NJ 07103, USA
Venous thromboembolism (VTE) is a potentially lifethreatening condition associated with both orthopedic surgery and cancer [1–3]. With incidence rates reported between < 1 and 22%, there is considerable variability in the prophylactic regimens between different practices [3–5]. The combination of orthopaedic procedure and neoplastic disease is two known factors which increase the risk of VTE; however, many other risk factors may pose an additional risk to patients developing and surviving VTE [3, 6–8]. Many oncologists utilize both chemical and mechanical to reduce the risk of developing a VTE, but these are not without an increased risk of associated complications [3, 4]. Studies investigating risk factors for VTE have been largely limited by the size of patient cohorts and heterogeneity of patient populations including both primary and metastatic bone lesions [4, 7, 9–11]. While there have been studies supporting long-term chemical prophylaxis, current recommendations do not specify the type or
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