Venous thromboembolism in patients with head and neck cancer after surgery

Abstract

The incidence of VTE in patients with head and neck cancer after resection and microvascular reconstruction ranged from 1.4% to 5.8%.

The effect of deep venous thrombosis on short‐term outcomes and cost of care after head and neck cancer surgery

“…Because these variables are prevalent in the HNCA population, HNCA patients represent a unique group at increased risk for DVT/PE in whom prevention may not always be possible. Although data on DVT prophylaxis were not available for this patient cohort, our observed incidence of postoperative DVT/PE in this study is similar to a recent, small, single‐institution study of venous thromboembolism in head and neck cancer patients13 and is higher than that observed in two older large cohorts of head and neck surgery patients 14, 15. Our incidence is also comparable to the 1.6% incidence DVT found in a recent study of 2,189 general surgery patients who received guideline‐directed DVT prophylaxis postoperatively 16.…”

Chemoprophylaxis for Venous Thromboembolism in Otolaryngology

“…8,10,12 The higher risk profile of these patients is reflected in our study population where 30% had a Caprini risk score of 7 or higher compared with 16% for all other patients. Interestingly, when stratified by risk level, the incidence of VTE for patients who did not receive chemoprophylaxis is higher in cases involving free tissue transfer than for other patients in all three risk levels ( Table 4).…”

“…Thai and colleagues 10 reported lower rates of between 1.4% and 5.8% for a similar population and, based on these findings, did not recommend routine VTE chemoprophylaxis without additional investigation into the benefit-to-risk ratio.…”

“…8,10,11 One method is the Caprini risk assessment model. [10][11][12] This model is used to determine each patient's individual risk for VTE. The Caprini model uses a point scoring system; the relative scores for each patient's risk factors are summed to produce a cumulative risk score that defines the patient's risk level and associated prophylaxis regimen.…”

Obesity and perioperative complications in head and neck free tissue reconstruction

“…Obese patients experience higher rates of flap loss (5.5%) in postmastectomy abdominal‐based free flap reconstruction . Increased BMI has also been shown to be a risk factor for perioperative medical complications (such as venous thromboembolism) after head and neck free flaps . In contrast, in a large prospective study of head and neck free flap recipients, medical complications were less common for those with a higher BMI .…”