Clinical characteristics, management strategies, and outcomes in patients with preoperative venous thromboembolism who underwent surgery: survey data from 2020 to 2022 by the Japanese Society of Anesthesiologists.

PURPOSE: To investigate the clinical characteristics of management strategies for, and outcomes in patients with preoperative venous thromboembolism (VTE) who underwent surgery in Japan.

METHODS

We categorized patients with preoperative VTE into the following three groups: pulmonary embolism (PE), proximal deep vein thrombosis (DVT), and distal DVT. We investigated baseline characteristics, including risk factors; perioperative treatment and prophylaxis, including anticoagulation; and postoperative outcomes, including postoperative VTE recurrence, bleeding, and death.

RESULTS

We divided 13,025 patients into PE (n = 2425, 19%), proximal DVT (n = 1792, 14%), and distal DVT groups (n = 8808, 68%). The PE group had the highest incidence of malignancy; the proximal DVT group had the highest incidence of leg fractures; and the distal DVT group had the lowest incidence of physical immobility. Furthermore, the PE group most frequently received preoperative anticoagulation therapy after VTE diagnosis, whereas the proximal DVT group most frequently received an inferior vena cava filter for intraoperative management. Death within 30 postoperative days was most common in the PE group. In addition, recurrent PE was most frequent in the PE group, whereas major bleeding events were least frequent in distal DVT group.

CONCLUSIONS

This study, based on nationwide anesthesiologic database, provides contemporary practice patterns and clinical outcomes in patients with preoperative VTE who underwent surgery in Japan. These findings may provide valuable information for healthcare providers involved in surgery.