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Mutsuhito Kikura, MD, PhD; Tomosue Takada, MD; Shigehito Sato, MD, PhD

Arch Surg. 2005;140:1210-1217.

Hypothesis  Preexisting morbidities are risk factors for perioperative arterial or venous thromboembolic events and subsequent death within 30 postoperative days.

Design  Prospective cohort study.

Setting  University-affiliated general hospital.

Patients  A total of 21 903 surgery patients treated from January 1, 1991, through December 31, 2002.

Main Outcome Measures  Independent risk factors for perioperative arterial or venous thromboembolic events.

Results  History of atrial fibrillation and coronary artery disease increased the risk of myocardial infarction (odds ratio [95% confidence interval], 4.3 [2.8-6.7]). History of stroke increased the risk of stroke (2.4 [1.4-4.1]) and death (4.7 [1.3-17.3]). Diabetes mellitus increased the risk of myocardial infarction (2.1 [1.3-3.2]), and hyperuricemia increased the risk of stroke (3.5 [1.2-9.8]), and both increased the risk of death (4.3 [1.3-14.1] and 11.8 [2.2-63.5], respectively). History of myocardial infarction increased the risk of deep vein thrombosis (7.7 [1.7-34.7]). Cancer increased the risk of all thromboembolism (2.4 [1.9-3.2]). Trend analysis showed that preexisting morbidities will increase 1.5-fold and thromboembolic events will increase 3-fold during the next decade.

Conclusion  Cardiac and cerebrovascular diseases, metabolic diseases, and cancer are becoming increasingly high-risk comorbidities for perioperative acute thromboembolism syndrome.

Author Affiliations: Department of Anesthesiology and Pain Clinic, Seirei-Mikatabara General Hospital (Drs Kikura and Takada), Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine (Dr Sato), and Department of Anesthesiology and Intensive Care, Hamamatsu Medical Center (Dr Kikura), Hamamatsu, Japan.

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