Venous Thromboembolism Chemoprophylaxis Adherence Rates After Major Cancer Surgery

作者：Charles D. Logan, Matthew T. Hudnall, Cary Jo R. Schlick, Dustin D. French, Brian Bartle, Dominic J. Vitello, Hiten Dilip Patel, Lauren M. Woldanski, Daniel Erik Abbott, Ryan P. Merkow, David D. Odell, David J. Bentrem · 发表于：JAMA Network Open · 年份：2023 · DOI：10.1001/jamanetworkopen.2023.35311 · 被引用次数：13 · 研究领域：Venous Thromboembolism Diagnosis and Management、Antiplatelet Therapy and Cardiovascular Diseases、Inflammatory Biomarkers in Disease Prognosis

Importance: Venous thromboembolism (VTE) represents a major source of preventable morbidity and mortality and is a leading cause of death in the US after cancer surgery. Previous research demonstrated variability in VTE chemoprophylaxis prescribing, although it is unknown how these rates compare with performance in the Veterans Health Administration (VHA). Objective: To determine VTE rates after cancer surgery, as well as rates of inpatient and outpatient (posthospital discharge) chemoprophylaxis adherence within the VHA. Design, Setting, and Participants: This retrospective cohort study within 101 hospitals of the VHA health system included patients aged 41 years or older without preexisting bleeding disorders or anticoagulation usage who underwent surgical treatment for cancer with general surgery, thoracic surgery, or urology between January 1, 2015, and December 31, 2022. The VHA Corporate Data Warehouse, Pharmacy Benefits Management database, and the Veterans Affairs Surgical Quality Improvement Program database were used to identify eligible patients. Data analysis was conducted between January 2022 and July 2023. Exposures: Inpatient surgery for cancer with general surgery, thoracic surgery, or urology. Main Outcomes and Measures: Rates of postoperative VTE events within 30 days of surgery and VTE chemoprophylaxis adherence were determined. Multivariable Poisson regression was used to determine incidence-rate ratios of inpatient and postdischarge chemoprophylaxis adher...