Incidence of venous thromboembolism in otolaryngology-head and neck surgery

Objective: To examine the incidence of venous thromboembolic disease in the otolaryngology-head and neck surgery (OTO-HNS) patient population. Design, Setting, and Patients: Review of medical records for all patients undergoing a surgical procedure during fiscal years 2008 to 2011 (July 1, 2008, through June 30, 2011) at an academic tertiary care medical center. Intervention: A total of 59 884 total surgical procedures among all the surgical services. Main Outcome Measures: The incidence of deep venous thrombosis and pulmonary embolism. Results: There were 5616 otolaryngology procedures performed during the study period. Clinically evident deep venous thrombosis developed in 3 patients; 2 of these patients also developed a pulmonary embolism. The overall incidence of deep venous thrombosis and pulmonary embolism in OTO-HNS was 0.05% and 0.035%, respectively. All patients who developed deep venous thrombosis or a pulmonary embolism in the OTO-HNS population were inpatients being treated for cancer. There were no deep venous thromboses or pulmonary emboli in patients undergoing same-day or overnight surgery or in patients without an active cancer. The OTO-HNS service had significantly lower rates of venous thromboembolism than did most other surgical specialties despite lower rates of adherence to venous thromboembolism prophylaxis guidelines. Conclusions: The incidence of deep venous thrombosis and pulmonary embolism among the OTO-HNS patient population at our academic center is lower than the incidence reported in previous studies (range, 0.1%-0.3%) and is significantly lower than the incidence observed in other surgical specialties. It is likely that patient- and specialty-specific factors as well as the more aggressive use of venous thromboembolism prophylaxis during recent years are at least partially responsible for the decreased incidence in our population.