Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study

Purpose Little is known regarding the magnitude and timing of the risk of VTE following inguinal hernia surgery. We aimed to determine the absolute and relative rates of venous thromboembolism (VTE) following planned inguinal hernia repair. Methods We analysed male adults with a first inguinal he...

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Main Authors: Humes, D.J., Abdul-Sultan, Alyshah, Walker, Alex J., Ludvigsson, Jonas F., West, Joe
Format: Article
Published: Springer Verlag 2018
Subjects:
Online Access:https://eprints.nottingham.ac.uk/49393/
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author Humes, D.J.
Abdul-Sultan, Alyshah
Walker, Alex J.
Ludvigsson, Jonas F.
West, Joe
author_facet Humes, D.J.
Abdul-Sultan, Alyshah
Walker, Alex J.
Ludvigsson, Jonas F.
West, Joe
author_sort Humes, D.J.
building Nottingham Research Data Repository
collection Online Access
description Purpose Little is known regarding the magnitude and timing of the risk of VTE following inguinal hernia surgery. We aimed to determine the absolute and relative rates of venous thromboembolism (VTE) following planned inguinal hernia repair. Methods We analysed male adults with a first inguinal hernia repair with no prior record of VTE from the Clinical Practice Research Datalink, linked to the Hospital Episode Statistics (2001–2011). Crude rates and adjusted hazard ratios (HR) of the first VTE were calculated using Cox regression analysis to compare specific time periods following the surgery compared to the general population. Results We identified 28,782 men who underwent an inguinal hernia repair with 53 (0.18%) having a first VTE in the 90 days following surgery. The overall rate of VTE in the first 90 days following surgery was 7.61 per 1000 person years (pyrs) (95% CI 5.82–9.96). Increasing age, a body mass index > 30 kg/m2 and an in-patient procedure were associated with an increased risk of VTE, when compared to the general population. The risk of VTE was highest in the 1st month following the surgery with a 2.3- (aHR 2.33; 95% CI 1.09–4.99) and 3.5- (aHR 3.47; 95% CI 2.07–5.83) fold increased risk compared to the general population for both day case and planned in-patient procedures, respectively. Conclusions Reassuringly, the absolute rates of VTE following inguinal hernia repair are low. Patients should be informed that their peak risk of VTE is during the 1st month following the surgery. Further studies on the optimum duration of thromboprophylaxis following surgery are required in high-risk patients undergoing hernia repair.
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spelling nottingham-493932020-05-04T19:26:49Z https://eprints.nottingham.ac.uk/49393/ Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study Humes, D.J. Abdul-Sultan, Alyshah Walker, Alex J. Ludvigsson, Jonas F. West, Joe Purpose Little is known regarding the magnitude and timing of the risk of VTE following inguinal hernia surgery. We aimed to determine the absolute and relative rates of venous thromboembolism (VTE) following planned inguinal hernia repair. Methods We analysed male adults with a first inguinal hernia repair with no prior record of VTE from the Clinical Practice Research Datalink, linked to the Hospital Episode Statistics (2001–2011). Crude rates and adjusted hazard ratios (HR) of the first VTE were calculated using Cox regression analysis to compare specific time periods following the surgery compared to the general population. Results We identified 28,782 men who underwent an inguinal hernia repair with 53 (0.18%) having a first VTE in the 90 days following surgery. The overall rate of VTE in the first 90 days following surgery was 7.61 per 1000 person years (pyrs) (95% CI 5.82–9.96). Increasing age, a body mass index > 30 kg/m2 and an in-patient procedure were associated with an increased risk of VTE, when compared to the general population. The risk of VTE was highest in the 1st month following the surgery with a 2.3- (aHR 2.33; 95% CI 1.09–4.99) and 3.5- (aHR 3.47; 95% CI 2.07–5.83) fold increased risk compared to the general population for both day case and planned in-patient procedures, respectively. Conclusions Reassuringly, the absolute rates of VTE following inguinal hernia repair are low. Patients should be informed that their peak risk of VTE is during the 1st month following the surgery. Further studies on the optimum duration of thromboprophylaxis following surgery are required in high-risk patients undergoing hernia repair. Springer Verlag 2018-01-15 Article PeerReviewed Humes, D.J., Abdul-Sultan, Alyshah, Walker, Alex J., Ludvigsson, Jonas F. and West, Joe (2018) Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study. Hernia . ISSN 1248-9204 Venous thrombosis inguinal hernia surgery https://link.springer.com/article/10.1007%2Fs10029-017-1716-6 doi:10.1007/s10029-017-1716-6 doi:10.1007/s10029-017-1716-6
spellingShingle Venous thrombosis
inguinal hernia
surgery
Humes, D.J.
Abdul-Sultan, Alyshah
Walker, Alex J.
Ludvigsson, Jonas F.
West, Joe
Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study
title Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study
title_full Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study
title_fullStr Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study
title_full_unstemmed Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study
title_short Duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study
title_sort duration and magnitude of postoperative risk of venous thromboembolism after planned inguinal hernia repair in men: a population-based cohort study
topic Venous thrombosis
inguinal hernia
surgery
url https://eprints.nottingham.ac.uk/49393/
https://eprints.nottingham.ac.uk/49393/
https://eprints.nottingham.ac.uk/49393/