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Risk of venous thromboembolism in bone and soft-tissue sarcoma patients undergoing surgical intervention: A report from prior to the initiation of SCIP measures

Authors

  • Timothy A. Damron MD,

    Corresponding author
    1. Upstate Orthopedic Surgery, Upstate Bone and Joint Center, Upstate Medical University, East Syracuse, New York
    • Professor, Orthopedic Surgery, Upstate Orthopedic Surgery, Upstate Bone and Joint Center, Upstate Medical University, 6620 Fly Road, East Syracuse, NY 13057. Fax: 315-464-5223
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  • Zabi Wardak BA,

    1. Upstate Orthopedic Surgery, Upstate Bone and Joint Center, Upstate Medical University, East Syracuse, New York
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  • Bradley Glodny MD,

    1. Upstate Orthopedic Surgery, Upstate Bone and Joint Center, Upstate Medical University, East Syracuse, New York
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  • William Grant EdD

    1. Upstate Orthopedic Surgery, Upstate Bone and Joint Center, Upstate Medical University, East Syracuse, New York
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    • Professor, Emergency Medicine.


Abstract

Background and Objectives

This study reviews incidence and risk factors for venous thromboembolism (VTE) in bone/soft-tissue sarcoma patients prior to the initiation of Surgical Care Improvement Program (SCIP) measures in October 2009.

Methods

A retrospective chart review identified 171 cases of bone (51) and soft-tissue (120) sarcoma. Data were extracted on demographics, histology, presence of metastasis at presentation, type of adjuvant therapy, and established risk factors for VTE. Risk factors and outcomes were analyzed using chi-square and logistic regression with the Fisher exact test.

Results

The rate of clinically diagnosed VTE was 4.1% (7/171). Only those patients undergoing chemotherapy were found to have a significantly increased risk of VTE (P = 0.04). Chemical prophylaxis showed a trend toward reduction in the risk of VTE (2.4% vs. 9.1%, P = 0.13). The number of individual patient prothrombotic risk factors showed a trend towards increased risk of VTE (P = 0.12).

Conclusions

The current rate of 4.1% is at the lower end of the range of reported incidence for musculoskeletal oncology patients. Furthermore, VTE did not occur only in patients with hip/thigh sarcomas, as previously reported by some. The trend for reduced incidence with chemoprophylaxis favors prophylactic measures but requires further substantiation in larger studies. J. Surg. Oncol. 2011;103:643–647. © 2011 Wiley-Liss, Inc.

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