TY - JOUR
T1 - The Attributable Mortality of Postoperative Bleeding Exceeds the Attributable Mortality of Postoperative Venous Thromboembolism
AU - Bellomy, Melissa L.
AU - Engoren, Milo C.
AU - Martin, Barbara J.
AU - Shi, Yaping
AU - Shotwell, Matthew S.
AU - Hughes, Christopher G.
AU - Freundlich, Robert E.
N1 - Funding Information:
From the *Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; †Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan; and Departments of ‡Quality, Safety, and Risk Prevention, §Biostatistics, and ∥Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee. Accepted for publication May 15, 2020. Funding: R.E.F. was supported by an National Center for Advancing Translational Sciences (NCATS) KL2 TR002245 Grant and also receives grant support from National Heart Lung and Blood Institute (NHLBI) 1K23HL148640. C.G.H. is supported by NHLBI R01HL111111 and National Institute of General Medical Sciences (NIGMS) R01GM120484 as well as funding from Dr Franz Kohler Chemie GmbH. The other authors are supported by institutional and/or departmental funding.
Publisher Copyright:
© (Anesth Analg 2021;132:82 8)
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Background: Bleeding and venous thromboembolic disease are considered important sources of postoperative morbidity and mortality. Clinically, treatment of these 2 disorders is often competing. We sought to better understand the relative contributions of bleeding and venous thromboembolic disease to postoperative attributable mortality in a national cohort. METHODS: A retrospective analysis of the 2006-2017 American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) database was performed to assess the adjusted odds ratio and attributable mortality for postoperative bleeding and venous thromboembolism, adjusted by year. RESULTS: After adjustment for confounding variables, bleeding exhibited a high postoperative attributable mortality in every year studied. Venous thromboembolism appeared to contribute minimal attributable mortality. CONCLUSIONS: Bleeding complications are a consistent source of attributable mortality in surgical patients, while the contribution of venous thromboembolic disease appears to be minimal in this analysis. Further studies are warranted to better understand the etiology of this disparity.
AB - Background: Bleeding and venous thromboembolic disease are considered important sources of postoperative morbidity and mortality. Clinically, treatment of these 2 disorders is often competing. We sought to better understand the relative contributions of bleeding and venous thromboembolic disease to postoperative attributable mortality in a national cohort. METHODS: A retrospective analysis of the 2006-2017 American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) database was performed to assess the adjusted odds ratio and attributable mortality for postoperative bleeding and venous thromboembolism, adjusted by year. RESULTS: After adjustment for confounding variables, bleeding exhibited a high postoperative attributable mortality in every year studied. Venous thromboembolism appeared to contribute minimal attributable mortality. CONCLUSIONS: Bleeding complications are a consistent source of attributable mortality in surgical patients, while the contribution of venous thromboembolic disease appears to be minimal in this analysis. Further studies are warranted to better understand the etiology of this disparity.
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U2 - 10.1213/ANE.0000000000004989
DO - 10.1213/ANE.0000000000004989
M3 - Article
C2 - 32675637
AN - SCOPUS:85098531825
SN - 0003-2999
VL - 132
SP - 82
EP - 88
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
IS - 1
ER -