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Association of the risk of a venous thromboembolic event in emergency vs elective general surgery

This study investigates if emergency case status is independently associated with VTE as compared to elective case status and evaluates the theory that emergency cases have a higher VTE risk than elective cases.

This study was a retrospective cohort study that included the following:

  • The American College of Surgeons National Surgical Quality Improvement Program database from January 1, 2005, to December 31, 2016, was used for all cholecystectomies, ventral hernia repairs (VHR), and partial colectomies (PC).
  • The three surgical procedures included in the study were selected to provide a list of cases commonly performed by both general surgeons and acute care surgeons and had both emergency and elective counterparts.
  • The consequences of emergency physiology and inflammatory etiologies were evaluated on the same surgery type.
  • If a patient had more than one of the three procedures, the patient was coded for the more invasive and potentially complicated procedure (the order of greatest to least severity was PC, VHR, and cholecystectomy).
  • The primary outcome was VTE at 30 days. In addition, a multivariable analysis controlling for age, sex, body mass index, bleeding disorder, disseminated cancer, laparoscopy approach, and surgery type was performed.