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SEATTLE—Routine screening for venous thromboembolism (VTE) may decrease morbidity and mortality among patients undergoing pneumonectomy for benign or malignant indications, according to researchers.
The group conducted a study that showed the rate of VTE diagnosis was 3 times higher for patients who underwent routine VTE screening post-pneumonectomy than for patients who were tested for VTE only after they exhibited symptoms.
Siva Raja MD, PhD, of the Cleveland Clinic in Ohio, presented this finding at the 95th Annual Meeting of the American Association for Thoracic Surgery.
He and his colleagues analyzed 112 patients who underwent pneumonectomy for benign and malignant indications and were screened for VTE. The team compared the rate of VTE diagnosis in this group to the rate in a previously published group of 336 similar patients who did not undergo VTE screening.
The rate of in-hospital VTEs in the screened group was almost 3 times higher than the rate in patients who were not screened—8.9% and 3.0%, respectively (P=0.008).
Over the 30-day post-operative period, the rate of VTE for screened patients was more than double the rate for unscreened patients—13% and 5.1%, respectively (P=0.007).
In the screened group, 10 of 112 patients had VTE detected by screening just before discharge, and 4 additional patients developed symptomatic VTE within 30 days despite a negative pre-discharge screen. In all, 20 patients in this group developed a VTE.
In both the screened and unscreened cohorts, the risk of VTE peaked 6 days after surgery and plateaued after 30 days.
“We find that a large proportion (50%) of VTEs occurred prior to the time of discharge, and the risk of developing symptomatic VTE remained elevated for 30 days,” Dr Raja said. “It is possible that the prevalence of VTE may be even higher should a comprehensive serial screening program be initiated.”
Dr Raja also noted that VTEs are a particular problem after pneumonectomy, since these patients often have low pulmonary reserve to withstand the impact of pulmonary embolism.
Indeed, this study showed that post-pneumonectomy patients who developed VTE had worse long-term survival than patients who did not develop clots, although the difference was not statistically significant (hazard ratio=2.1, P=0.08).
Still, Dr Raja said these results suggest that patients undergoing pneumonectomy receive anticoagulants for a longer duration, as well as undergo repeat screening test for VTE even after hospital discharge. 
Image by Kevin MacKenzie
SEATTLE—Routine screening for venous thromboembolism (VTE) may decrease morbidity and mortality among patients undergoing pneumonectomy for benign or malignant indications, according to researchers.
The group conducted a study that showed the rate of VTE diagnosis was 3 times higher for patients who underwent routine VTE screening post-pneumonectomy than for patients who were tested for VTE only after they exhibited symptoms.
Siva Raja MD, PhD, of the Cleveland Clinic in Ohio, presented this finding at the 95th Annual Meeting of the American Association for Thoracic Surgery.
He and his colleagues analyzed 112 patients who underwent pneumonectomy for benign and malignant indications and were screened for VTE. The team compared the rate of VTE diagnosis in this group to the rate in a previously published group of 336 similar patients who did not undergo VTE screening.
The rate of in-hospital VTEs in the screened group was almost 3 times higher than the rate in patients who were not screened—8.9% and 3.0%, respectively (P=0.008).
Over the 30-day post-operative period, the rate of VTE for screened patients was more than double the rate for unscreened patients—13% and 5.1%, respectively (P=0.007).
In the screened group, 10 of 112 patients had VTE detected by screening just before discharge, and 4 additional patients developed symptomatic VTE within 30 days despite a negative pre-discharge screen. In all, 20 patients in this group developed a VTE.
In both the screened and unscreened cohorts, the risk of VTE peaked 6 days after surgery and plateaued after 30 days.
“We find that a large proportion (50%) of VTEs occurred prior to the time of discharge, and the risk of developing symptomatic VTE remained elevated for 30 days,” Dr Raja said. “It is possible that the prevalence of VTE may be even higher should a comprehensive serial screening program be initiated.”
Dr Raja also noted that VTEs are a particular problem after pneumonectomy, since these patients often have low pulmonary reserve to withstand the impact of pulmonary embolism.
Indeed, this study showed that post-pneumonectomy patients who developed VTE had worse long-term survival than patients who did not develop clots, although the difference was not statistically significant (hazard ratio=2.1, P=0.08).
Still, Dr Raja said these results suggest that patients undergoing pneumonectomy receive anticoagulants for a longer duration, as well as undergo repeat screening test for VTE even after hospital discharge.
Image by Kevin MacKenzie
SEATTLE—Routine screening for venous thromboembolism (VTE) may decrease morbidity and mortality among patients undergoing pneumonectomy for benign or malignant indications, according to researchers.
The group conducted a study that showed the rate of VTE diagnosis was 3 times higher for patients who underwent routine VTE screening post-pneumonectomy than for patients who were tested for VTE only after they exhibited symptoms.
Siva Raja MD, PhD, of the Cleveland Clinic in Ohio, presented this finding at the 95th Annual Meeting of the American Association for Thoracic Surgery.
He and his colleagues analyzed 112 patients who underwent pneumonectomy for benign and malignant indications and were screened for VTE. The team compared the rate of VTE diagnosis in this group to the rate in a previously published group of 336 similar patients who did not undergo VTE screening.
The rate of in-hospital VTEs in the screened group was almost 3 times higher than the rate in patients who were not screened—8.9% and 3.0%, respectively (P=0.008).
Over the 30-day post-operative period, the rate of VTE for screened patients was more than double the rate for unscreened patients—13% and 5.1%, respectively (P=0.007).
In the screened group, 10 of 112 patients had VTE detected by screening just before discharge, and 4 additional patients developed symptomatic VTE within 30 days despite a negative pre-discharge screen. In all, 20 patients in this group developed a VTE.
In both the screened and unscreened cohorts, the risk of VTE peaked 6 days after surgery and plateaued after 30 days.
“We find that a large proportion (50%) of VTEs occurred prior to the time of discharge, and the risk of developing symptomatic VTE remained elevated for 30 days,” Dr Raja said. “It is possible that the prevalence of VTE may be even higher should a comprehensive serial screening program be initiated.”
Dr Raja also noted that VTEs are a particular problem after pneumonectomy, since these patients often have low pulmonary reserve to withstand the impact of pulmonary embolism.
Indeed, this study showed that post-pneumonectomy patients who developed VTE had worse long-term survival than patients who did not develop clots, although the difference was not statistically significant (hazard ratio=2.1, P=0.08).
Still, Dr Raja said these results suggest that patients undergoing pneumonectomy receive anticoagulants for a longer duration, as well as undergo repeat screening test for VTE even after hospital discharge.