Even Outpatient Surgery Comes With Blood Clots

Dangerous blood clots problematic in outpatient surgery for highest risk patients

(RxWiki News) Hospitalized patients who undergo surgery aren't the only ones at risk of suffering a dangerous blood clot. Patients undergoing outpatient procedures also are at risk.

More than 60 percent of surgical procedures are now performed in an outpatient setting.  

Patients are not often warned of the risk of dangerous blood clots that could become dislodged and travel to obstruct lung arteries, causing a potentially life-threatening pulmonary embolism.

"Ask your doctor about blood clot risks."

Christopher J. Pannucci, MD, lead study author and a resident in the University of Michigan's Section of Plastic Surgery, said that outpatient surgery was once used only for simple procedures, but it now includes procedures ranging from plastic surgery to cancer operations and orthopedic surgery. He noted that not all patients are young and healthy.

He found that one in every 84 of the highest risk outpatient surgery patients suffer a potentially deadly blood clot after their procedure.

Previous research has indicated that despite the presence of risk factors for a blood clot, less than 50 percent of outpatient centers have prevention guidelines in place, and fewer adhere to them.

During the study investigators reviewed more than 200,000 outpatient surgeries performed at a variety of medical centers across the U.S. included in the American College of Surgeons’ National Surgical Quality Improvement Program Participant Use File.

Though patients that undergo vein surgery or arthroscopic surgery are well known to be at an increased risk of blood clots, researchers found that a majority of patients had multiple factors that could increase their risk of blood clots. These factors included age, length of surgery, type or length of procedure, active cancer and patients who were pregnant at the time of the operation.

Investigators used the findings to create and validate a risk stratification tool that could better predict a patient's odds of suffering a blood clot. The tool could be used to identify a risk between 0.04 percent and 1.12 percent, a 20-fold risk.

“These data are in stark contrast to provider and patient expectations that outpatient surgery is a low-risk event,” Dr. Pannucci said. “It also underscores the importance of evaluating a patient’s individual risk factors as opposed to procedure-type alone.”

The study was recently published in journal Annals of Surgery.

Review Date: 
April 23, 2012