While the risk of post-operative pulmonary embolism (PE) has been reported to be highest during the first five weeks after surgery, a new research suggests the risk remains elevated beyond six weeks after surgery.
For the study, researchers looked at the duration of an increased risk of PE after six types of surgery (vascular, gynaecological, gastrointestinal, hip or knee replacement, fractures and other orthopaedic operations) among 60,703 cancer-free middle-age adults using data from a French national inpatient database.
The study found that the risk of early post-operative PE was elevated for all types of surgery and highest for gynaecological surgery (odds ratio [OR] 8.17) and surgery for fractures (OR 8.34). The authors reported that the excess risk of post-operative PE remained significantly elevated between six and 12 weeks after surgery, but the risk was not clinically significant beyond 18 weeks post-surgery for all types of procedures.
“The persistence of this excess risk suggests that further randomised clinical trials are required to evaluate whether the duration of postoperative prophylactic anticoagulation should be extended and to define the optimal duration of treatment with regard to both the thrombotic and bleeding risks," the authors said.
The research is published in JAMA Surgery.