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Association between venous thromboembolism rates and different prophylactic anticoagulation regimens in patients undergoing free flap reconstruction of the head and neck region
Rakan Saadoun, MD; Fuat Baris Bengur, MD; Elizabeth A. Moroni MD; Mark Kubik, MD; Shaum Sridharan, MD; Mario G. Solari, MD
University of Pittsburgh
2022-01-13
Presenter: Rakan Saadoun
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Mario G. Solari
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
PURPOSE: Venous thromboembolism (VTE) is a life-threatening complication seen in 1.4% to 5.8% of patients after free tissue transfer to the head and neck (H&N) region. There is no consensus on the optimal chemoprophylaxis regimen. Enoxaparin 30 mg twice daily (BID) and heparin 5000 units three times daily (TID) are among the most common. The aim of this study was to compare the 30-day VTE and bleeding rate after surgery among these two different prophylaxis regimens.
METHODS: The population included in this retrospective cohort study are patients who underwent H&N reconstruction with free tissue transfer. Patients received either enoxaparin 30 mg BID (group A) or heparin 5000 units TID (group B) for venous thromboembolism prophylaxis. VTE and hematoma that required surgical intervention within 30 days of surgery were retrospectively recorded. Statistical analysis was performed using chi-square and T-tests.
RESULTS: 737 patients were included. The mean Caprini score was 6.451.65. VTE and hematoma evacuation rates among all patients were 4.5% and 5.6%, respectively. The mean Caprini score between groups A (n=664) and B (n=73) was not statistically significant (6.47±1.68 vs. 6.32±1.34, p=0.457). VTE rates in group A were significantly lower than B (3.9% vs. 9.6%, p= 0.026). The difference in hematoma rates between the two groups failed to reach statistical significance (5.6 vs. 5.5, p= 0.974).
CONCLUSIONS: Enoxaparin 30mg BID achieved significantly lower VTE rates compared to heparin 5000 units TID, while maintaining similar postoperative bleeding rates.
