Higher Risk for Recurrent VTE Months After Surgery

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

In patients with prior venous thromboembolism (VTE), surgery is associated with increased risk for recurrence for up to 6 months, according to a study in JAMA Network Open.

Dutch researchers identified 3700 patients aged 70 and under with VTE who were followed for a median of 6 years. Nearly 16% of patients had undergone at least one surgery.

Surgery patients had a higher cumulative risk for VTE recurrence at 3 months, compared with those who hadn’t had surgery (3.3% vs. 0.8%). The risk was still significant at 6 months post-surgery.

Factor V Leiden mutation and male sex were associated with increased risk for VTE recurrence. Cancer-related surgery, as well as orthopedic, gastrointestinal, and heart-lung procedures had the highest recurrence risks.

Guidelines recommended thromboprophylaxis in these patients unless contraindicated. The authors conclude: “Our results stress the need for a revision of the thromboprophylactic approach following surgery in patients with a history of VTE, the duration and dosage of which may need to be intensified and individualized.”