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Invited Critique
February 01, 2007

Association Between Venous Thromboembolism and Perioperative Allogeneic Transfusion—Invited Critique

Arch Surg. 2007;142(2):133. doi:10.1001/archsurg.142.2.133

Venous thromboembolism in surgical patients continues to be a potentially fatal complication. Nilsson and colleagues have attempted to add to our understanding of the potential risk factors for postoperative VTE by analysis of a reportedly reliable hospital discharge database that captures all discharge information from the 52 nonfederal acute care hospitals in Maryland between January 1, 1994, and December 31, 2000. They found that the overall reported incidence of VTE in a well-defined patient population undergoing colon resection because of malignancy was 1%. More important but not unexpected, they found that VTE portended a nearly 4-fold increase in mortality and significant increases in hospital length of stay and hospital charges. They also found independent association of several other factors with VTE, namely, transfusion, female sex, age older than 80 years, moderate to severe liver disease, hospital admission through the ED, and surgeon low annual case volume (<5 cases per year). The association of female sex with increased risk of VTE was noted only when the female patient received a blood transfusion.

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