Following GI cancer surgery, the 90-day incidence of VTE was 2.1%, and both Caprini (AUC 0.65; 95% CI 0.57-0.72) and IMPROVE models demonstrated only fair discrimination for predicting VTE.
Cohort (n=2,702)
VTE remains a significant complication after GI cancer surgery with high mortality risk, highlighting the need for better risk prediction models and increased use of post-discharge prophylaxis.
ABSTRACT Background and Methods Venous thromboembolism (VTE) is common and preventable following surgery for gastrointestinal (GI) cancer. In this retrospective cohort study, we aimed to characterize VTE risk factors, prophylaxis, and outcomes among patients who underwent surgery for GI cancer between 2019 and 2021 at Kaiser Permanente Southern California. The discrimination of the Caprini and IMPROVE risk models for predicting VTE was assessed using the area under the receiver operating characteristic curve (AUC). Results Among 2702 patients, the 90‐day incidence of perioperative VTE was 2.1%. VTE was associated with older age, prior VTE, thrombophilia, low serum albumin, and blood transfusion, but not procedure time or surgical approach. VTE was especially common among patients with gastric cancer (4.5%). In‐hospital prophylaxis was nearly universal, but post‐discharge prophylaxis was uncommonly utilized (22.9%). VTE was associated with a five‐fold increase in 90‐day mortality. Both Caprini (AUC 0.65, 95% CI 0.57‐0.72) and IMPROVE (AUC 0.65, 95% CI 0.57–0.73) models demonstrated only fair discrimination. Conclusions Despite adherence with recommended in‐hospital prophylaxis, VTE remains an important complication following GI cancer surgery, carrying with it an increased risk of mortality. Discussion Suboptimal discrimination of risk prediction models and underutilization of post‐discharge prophylaxis represent ongoing opportunities for quality improvement.
Qi et al. (Sun,) conducted a cohort in Gastrointestinal (GI) cancer (n=2,702). VTE prophylaxis and risk prediction models (Caprini and IMPROVE) was evaluated on 90-day incidence of perioperative VTE. Following GI cancer surgery, the 90-day incidence of VTE was 2.1%, and both Caprini (AUC 0.65; 95% CI 0.57-0.72) and IMPROVE models demonstrated only fair discrimination for predicting VTE.