Chest
Original ResearchVenous Thromboembolic DiseaseIncidence and Risk Factors for Venous Thromboembolic Disease in Podiatric Surgery
Section snippets
Materials and Methods
We analyzed a large not-for-profit HMO database serving > 485,000 members using an integrated, group-model health delivery system to identify patients who had undergone podiatric procedures during the period from December 1999 to November 2004. A robust computerized electronic medical record system of all patient care activity is accessible. This study was approved by the Kaiser Permanente Northwest institutional review board; patient data were deidentified according to institutional review
Results
A total of 7,264 patients underwent 16,804 podiatric surgical procedures from December 1999 to November 2004 (Table 2); 5,128 patients underwent a single procedure, and 2,136 patients underwent multiple procedures. There were 2,254 patients with inpatient procedures and 5,010 patients with outpatient procedures.
Of the 7,264 patients undergoing podiatric surgery during this time period, there were 12 symptomatic DVTs and 10 symptomatic PEs for an overall number of 22 VTE events, giving an
Discussion
Our retrospective study of > 7,000 podiatry patients is the largest clinical investigation to date of VTE rates in podiatric surgery. The results of the analysis have four major findings. First, for all patients undergoing podiatric surgery, the overall rate of podiatric procedure-related symptomatic VTE is low at 0.30%. Second, we found a significant increased risk for postprocedure VTE in patients with prior VTE (4.6%), those receiving HRT/OCP (0.55%), or patients who were obese (0.48%),
Acknowledgment
We are indebted to Kathleen Souders for help with the administrative database, Kevin Lutz and Dixie Sweo for assistance with the preparation of this manuscript, and Dr. Karen Mularski for thoughtful critiques.
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This study was supported by a grant from Kaiser Permanente Northwest Community Benefit Investment. The Kaiser Permanente Northwest Community Benefit Investment supports collaboration between clinical investigators from Northwest Permanente Medical Group and the Center for Health Research.
Dr. DeLoughery receives grant support or honoraria from GlaxoSmithKline, Aventis, and Baxter. The other authors have no conflicts of interest to disclose.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).