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Should all patients receive the same prophylaxis? Racial variation in the risk of venous thromboembolism after major abdominal operations
- Source :
- American journal of surgery. 222(5)
- Publication Year :
- 2021
-
Abstract
- Whether prevention strategy for postoperative venous thromboembolism (VTE) should be tailored across racial groups remains unknown.Patients who underwent major abdominal operation in the Nationwide Inpatient Sample (NIS) were examined. Our primary outcome was postoperative VTE, and the secondary outcome was postoperative bleeding. Multivariable logistic regression analyses were performed and validated with the National Surgical Quality Improvement Program (NSQIP) database.781,888 patients from NIS were analyzed. Overall VTE rate was 2.0%. Compared to White patients, Hispanic (OR 0.85, 95% CI 0.78-0.93, p 0.01) and Asian patients (OR 0.49, 95% CI 0.40-0.61, p 0.01) had significantly lower risks for VTE. In contrast, Asian patients had a significantly higher risk of bleeding (OR 1.39, 95% CI 1.24-1.56, p 0.01). Similar trends were observed in NSQIP.The risk-benefit ratio of postoperative VTE prophylaxis for Asian patients is roughly three times higher than that for White patients, suggesting a tailored approach is necessary.
- Subjects :
- Adult
Male
medicine.medical_specialty
Tailored approach
Adolescent
Black People
Vte prophylaxis
Postoperative Hemorrhage
Logistic regression
White People
03 medical and health sciences
Young Adult
0302 clinical medicine
Primary outcome
Asian People
Risk Factors
Internal medicine
Medicine
Humans
030212 general & internal medicine
Digestive System Surgical Procedures
business.industry
Racial Groups
Anticoagulants
Racial group
General Medicine
Venous Thromboembolism
Middle Aged
Acs nsqip
030220 oncology & carcinogenesis
Surgery
Female
Abdominal operations
business
Venous thromboembolism
Subjects
Details
- ISSN :
- 18791883
- Volume :
- 222
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- American journal of surgery
- Accession number :
- edsair.doi.dedup.....328bade1ebc3d0f7bed2aeb2d11ae984