• BMJ · Jan 2014

    Impact of sepsis on risk of postoperative arterial and venous thromboses: large prospective cohort study.

    • Jacques D Donzé, Paul M Ridker, Samuel R G Finlayson, and David W Bates.
    • Division of General Internal Medicine, Bern University Hospital, 3010 Bern, Switzerland Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 02120 Boston, Massachusetts, USA Harvard Medical School, 02115 Boston, Massachusetts, USA donze.author@gmail.com.
    • BMJ. 2014 Jan 1;349:g5334.

    ObjectivesTo evaluate the impact of preoperative sepsis on risk of postoperative arterial and venous thromboses.DesignProspective cohort study using the National Surgical Quality Improvement Program database of the American College of Surgeons (ACS-NSQIP).SettingInpatient and outpatient procedures in 374 hospitals of all types across the United States, 2005-12.Participants2,305,380 adults who underwent surgical procedures.Main Outcome MeasuresArterial thrombosis (myocardial infarction or stroke) and venous thrombosis (deep venous thrombosis or pulmonary embolism) in the 30 days after surgery.ResultsAmong all surgical procedures, patients with preoperative systemic inflammatory response syndrome or any sepsis had three times the odds of having an arterial or venous postoperative thrombosis (odds ratio 3.1, 95% confidence interval 3.0 to 3.1). The adjusted odds ratios were 2.7 (2.5 to 2.8) for arterial thrombosis and 3.3 (3.2 to 3.4) for venous thrombosis. The adjusted odds ratios for thrombosis were 2.5 (2.4 to 2.6) in patients with systemic inflammatory response syndrome, 3.3 (3.1 to 3.4) in patients with sepsis, and 5.7 (5.4 to 6.1) in patients with severe sepsis, compared with patients without any systemic inflammation. In patients with preoperative sepsis, both emergency and elective surgical procedures had a twofold increased odds of thrombosis.ConclusionsPreoperative sepsis represents an important independent risk factor for both arterial and venous thromboses. The risk of thrombosis increases with the severity of the inflammatory response and is higher in both emergent and elective surgical procedures. Suspicion of thrombosis should be higher in patients with sepsis who undergo surgery.© Donzé et al 2014.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…