Elliot M. Levine
Illinois Masonic Medical Center, USA
Title: Risk Stratification and Prophylaxis of Venous Thromboembolic Events in Obstetrics
Biography
Biography: Elliot M. Levine
Abstract
Objective: To identify the risk factors for perioperative venous thromboembolism, and the possible consequences of chemical thromboprophylaxis used with cesarean delivery. Study Design: An Enterprise Data Warehouse (EDW) of a multi-hospital system was queried to obtain the incidence of and risk factors for perioperative venous thromboembolism (VTE) and the use of chemical thromboprophylaxis (CTP). Results: Of 337,174 surgical patients over the course of 2010-2013, Cesarean Delivery (CD) occurred 24,608 times, with chemical VTE prophylaxis being provided 931 times and 23,677 times without such prophylaxis. CTP was provided a total of less than 4% of the time. Hemorrhagic complications were recorded 0.08% of the time (0.2% when CTP was provided, and 0.07% without it). Though this was not found to be a statistically significant difference (p = .13), it may still warrant our concern, regarding the appropriateness of using CTP for all cesarean deliveries. Conclusion: Chemical thromboprophylaxis may have the risk of associated hemorrhage with its use, and it may be worthwhile to use risk stratification to decide whether or not to use it for surgical prophylaxis in particular cesarean cases.