NUR 03.8 - Venous Thrombosis events associated with Thoracic Surgery in a Teaching Hospital: 2012 – 2022

Background: Thoracic surgery is known to increase the risk of venous thromboembolism (VTE). The reported incidence ranges from 1.6% to 17.9% with most events occurring post-discharge. The optimal duration of thromboprophylaxis is unknown. The local policy around VTE prophylaxis is to use low molecular weight heparin as inpatient and prior to 2021 also to use anti-embolic stockings.

Aims: To investigate the number of VTE events diagnosed within university hospitals Plymouth between 2012 – 2022 following thoracic surgery to look at whether the existing VTE prophylaxis used is appropriate.

Methods: The study looks at a single thoracic surgeons’ data over the study period and cross checked with positive VTE events to identify cases where thrombosis occurred within 90 days thus hospital acquired VTE. All VTE events are identified using radiology records and positive events where thoracic surgery had occurred were included within this study.

Results: 705 operations were performed with 391 male (55%) and 314 female (41%) mean average age of 64 (SD 12.871) and an age range of 20 to 92. The operations were 561 routine (80%) with the reminder, 20% being either emergency or urgent cases. There were 551 (78%) cases were patient had a diagnosis of active cancer and the biggest other reason for surgery being trauma seen in 25 cases (4%). There were 12 VTE events 5 right PE, 2 left PE, 3 bilateral PE and 2 upper arm thrombosis. This equates to an incidence rate of 1.7% (95% CI 0.97 – 3.09). Of these 12 cases 10 (83%) were in patients with a cancer diagnosis with 1 case seen in a trauma patient (1/25 4%).

Conclusion(s): This data suggests that in UHP the risk of VTE post-thoracic surgery using a standard thromboprophylaxis protocol is relatively low. Further review of positive events is needed to identify whether any common themes are seen.