Venous thromboembolism (VTE) accounts for a majority of preventable morbidity and mortality after cancer surgery. VTE events that require hospital readmission are potentially life-threatening; however, data on the frequency of these events beyond the 30-day postoperative period remain limited.

A recent retrospective study determined the rates, outcomes, and predictive factors of readmissions relating to VTE up to 180 days after complex cancer operations, using a national data set.

Data of 126104 patients who underwent a complex cancer operation (defined as cystectomy, colectomy, esophagectomy, gastrectomy, liver/biliary resection, lung/bronchus resection, pancreatectomy, proctectomy, prostatectomy, or hysterectomy) for a corresponding cancer diagnosis were analyzed.

The proportion of 30-, 90-, and 180-day VTE readmissions after complex cancer surgery, factors associated with readmissions, and outcomes monitored during readmission visit, including mortality, length of stay, hospital cost, and readmission to index vs non-index hospital were assessed.

The results described 58.7% of patients were men, with a mean age of 65 years. 30-, 90-, and 180-day VTE-associated readmission rates were found to be 0.6%, 1.1% and 1.7% respectively. 1331 patients were readmitted for VTE within 90 days, among which, 34.3% of initial readmission were to a different hospital than the index surgery hospital, with a median length of stay of 5 days, the median cost of $8102, and death reported in 9.2% of patients. Independent factors of readmission included type of operation, scores for severity and risk of mortality, age of 75 to 84 years, female gender, nonelective index admission, more number of comorbidities and experiencing a major postoperative complication during the index admission.

Thus, VTE-related readmissions after complex cancer surgery can increase sufficiently beyond 30 days after surgery. the burden of VTE in postoperative patients should be decreased by Quality improvement efforts measuring and accounting for these late VTE-related readmissions.

Source: Mallick S, Aiken T, Varley P, et al. Readmissions from Venous Thromboembolism after Complex Cancer Surgery. JAMA Surg. Published online January 26, 2022. doi:10.1001/jamasurg.2021.7126