P-163A PRELIMINARY STUDY ON RETROSPECTIVE EVALUATION OF PULMONARY EMBOLISM RISK ASSESSMENT, THROMBOPROPHYLAXIS AND PULMONARY EMBOLISM INCIDENCE AFTER THORACIC SURGERY

Abstract

Objectives: Venous thromboembolism (VTE) can be a devastating postoperative complication. Pulmonary embolism (PE) always occurs alone and does not accompany with deep venous thrombosis (DVT) after thoracic surgery. Appropriate risk stratification for PE is essential to provide appropriate thromboprophylaxis and avoid morbidity and mortality. Our hospital has a large thoracic surgical population of 8000-10 000 cases every year, while is a high outlier for postoperative PE. This study was designed to retrospectively evaluate the Caprini VTE risk assessment model and the changing awareness of surgeons on inpatient PE incidence. Methods: We investigated a total of 1000 patients, including 500 who underwent surgical operations in June 2015 and 500 in June 2016. We recorded the Caprini score when the patients were transferred out from intensive care unit (ICU) after surgical operation. The baseline characteristics, the pharmacological prophylaxis and the inpatient PE incidence were also studied. Results: Forty-two patients were scored low risk (4.2%), 634 moderate risk (63.4%), and 324 high risk (32.4%). There was no significant difference in the distribution of Caprini risk categories between 2015 and 2016. There was also no statistical difference in the baseline characteristics, including age, gender, body mass index, surgical procedures, length of stay in ICU, early ambulation and pathologic diagnosis, when comparing 2015 with 2016 patients. However, only 19% of 2015 patients received pharmacological prophylaxis, while the rate reached 65.4% in 2016 (P < 0.01). In 2015, out of 500 patients, there were 4 cases (0.8%) in whom PE occurred during their inpatient time. In 2016, there was only 1 case (0.2%). Conclusions: Implementation of a PE risk assessment protocol with appropriate thromboprophylaxis was efficient and feasible for providers and thoracic surgical patients.