Trends in venous thromboembolism prophylaxis in gynecologic surgery for benign and malignant indications
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GENERAL GYNECOLOGY
Trends in venous thromboembolism prophylaxis in gynecologic surgery for benign and malignant indications Sbaa K. Syeda1,4 · Ling Chen1 · June Y. Hou1,3,4 · Ana I. Tergas1,2,3,4 · Fady Khoury‑Collado1,3,4 · Alexander Melamed1,3,4 · Caryn M. St. Clair1,3,4 · Melissa K. Accordino1,3,4 · Alfred I. Neuget1,2,3,4 · Dawn L. Hershman1,2,3,4 · Jason D. Wright1,3,4 Received: 25 May 2020 / Accepted: 2 July 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Venous thromboembolism (VTE) is a leading cause of perioperative morbidity and mortality. We analyzed the trends in use of VTE prophylaxis over time in women undergoing hysterectomy for both benign and malignant indications. Methods The Premier Database was used to identify women who underwent hysterectomy from 2011 to 2017. Women were stratified by indication for surgery (benign or malignant) and route of hysterectomy. VTE prophylaxis was classified as none, mechanical, pharmacologic, or combination (mechanical and pharmacologic). Trends in use of prophylaxis over time were analyzed. Multivariate models were developed to examine predictors of use of prophylaxis. Results Among 920,477 patients identified, 579,824 (63.0%) received VTE prophylaxis, including 15.4% who received pharmacologic, 34.5% who received mechanical, and 13.1% who received combination prophylaxis. Overall use of prophylaxis declined annually from 68.1% in 2011 to 56.7% in 2017 (P
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