Creation and Validation of a Condition-Specific VTE Risk Assessment Tool for Open Ventral Hernia Repair Patients
Christopher J. Pannucci, MD MS1, Marten N. Basta, BS2, John P. Fischer, MD2, Stephen J. Kovach, MD2.
1University of Utah, Salt Lake City, UT, USA, 2University of Pennsylvania, Philadelphia, PA, USA.
Patients who need open ventral hernia repair (VHR) are at unknown risk for venous thromboembolism (VTE). We utilized the ACS-NSQIP database to identify 30-day VTE risk factors and to create and validate an open VHR-specific VTE risk assessment model (RAM).
All ACS-NSQIP patients who had open VHR over eight years were identified. The primary outcome was 30-day VTE. Regression and bootstrap-based analysis created a weighted, open VHR-specific VTE RAM. The RAM was used to risk-stratify patients for 30-day VTE risk and 30-day risk for other medical and surgical complications.
Among 89,935 open VHR patients, 30-day VTE rate was 1.1%. The weighted risk score (Figure 1) identified a 22-fold variability (from 0.24% to 5.49%) in VTE risk among all patients (Figure 2). The risk score also risk-stratified for 30-day medical and surgical complications, inpatient stay duration, and mortality (Figure 3).
30-day VTE risk after open VHR is 1.1%, but a 22-fold variability in risk exists among the overall hernia. Our calculated VTE risk score risk-stratifies for both VTE and 30-day adverse events.
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