Symptomatic venous thromboembolism in Chinese patients after gynecologic surgery: incidence and disease pattern

BACKGROUND: Venous thromboembolism is a common cause of postoperative morbidity and mortality in Caucasian populations, but it is widely believed that this complication is rare in Chinese. METHODS: We conducted a retrospective study from January 1998 to December 2000. Women with thromboembolic diseases after gynecologic surgery were identified and their medical records were reviewed. RESULTS: During the study period, thirty-one women were diagnosed as having thromboembolic disease after gynecologic surgery. Over the study period, the total number of operations was 6077, giving an incidence of 5.10/1000 operations. There were two cases of pulmonary embolism and the others had deep vein thrombosis of which 90% were limited to calf veins only. The incidences were significantly higher in 1999 and 2000 (7.59 and 6.85/1000 operations, respectively) than that in 1998 (1.7/1000 operations) (P = 0.015), after a case of maternal death due to pulmonary embolism in early 1999. Most cases of thromboembolism were diagnosed after major surgery for malignancy (n = 14) or benign conditions (n = 12). In the remaining cases, three had evacuation of the uterus for retained products of conception and two had laparoscopy for suspected ectopic pregnancies. CONCLUSIONS: Thromboembolic disease is not uncommon among Chinese women after gynecologic surgery. The incidence is similar to that of the Caucasian population, although the sites of vascular occlusion were different. The long belief that thromboembolism is rare among Chinese is at least partly due to under-diagnosis.