耳鼻咽喉头颈外科各亚专科的静脉血栓栓塞风险：一项全国数据库分析
Venous Thromboembolism Risk Across Otolaryngology-Head and Neck Surgery Subspecialties: A National Database Analysis.
文献信息
| PMID | 42765470 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Shannon S Wu |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic & Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, California, USA. |
| 期刊 | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评估耳鼻咽喉头颈外科（OHNS）各亚专科之间及内部的静脉血栓栓塞（VTE）发生率。
研究设计： 回顾性全国数据库研究。
研究场所： 查询Atropos数据库，该数据库为美国全国范围内聚合的6600万患者队列，纳入接受OHNS手术的患者。
方法： 评估2015年至2025年间至少有一个OHNS手术现行程序术语代码的成年患者，结局为90天VTE。比较OHNS各亚专科内部及之间的术后VTE发生率。使用单变量分析评估VTE结局的危险因素。
结果： 共纳入277,187例接受OHNS手术的患者（平均年龄58.6±18.7岁，46.8%为男性）。术后VTE发生于1735例（0.63%）患者。VTE发生率最高的是头颈外科（1.3%），其次是喉科（1.0%）、鼻科（0.6%）、面部整形与重建外科（0.5%）、耳科（0.5%）和睡眠外科（0.3%）。观察到各亚专科内部不同手术组的VTE发生率存在差异。VTE发生率最高的手术组为游离组织移植（6.1%）、侧颅底手术（4.4%）、环咽肌切开术（3.1%）和前颅底手术（3.1%）。既往VTE（OR 12.3 [95%置信区间，11.2-13.4]）是术后VTE风险最高的协变量。
结论： 尽管总体VTE发生率较低（0.6%），但观察到亚专科间及亚专科内VTE发生率的差异，并且一部分OHNS手术具有显著更高的VTE风险。这些发现可能为外科医生关于化学预防的决策提供信息。
英文摘要
OBJECTIVE: To assess venous thromboembolism (VTE) rates across the spectrum of otolaryngology-head and neck surgery (OHNS) between and within subspecialties.
STUDY DESIGN: Retrospective national database study.
SETTING: The Atropos database, a national aggregated cohort of 66 million patients across the United States, was queried for patients who underwent OHNS surgery.
METHODS: Adult patients who had at least one Current Procedural Terminology code for OHNS procedures between 2015 and 2025 were assessed for the outcome of 90-day VTE. Postoperative VTE rates were compared within and between OHNS subspecialties. Risk factors for VTE outcomes were assessed using univariable analysis.
RESULTS: 277,187 patients (mean age 58.6 ± 18.7 years, 46.8% male) who had OHNS surgery were included. Postoperative VTE occurred in 1735 (0.63%) patients. VTE rates were highest in head and neck (1.3%), followed by laryngology (1.0%), rhinology (0.6%), facial plastic and reconstructive surgery (0.5%), otology (0.5%), and sleep surgery (0.3%). Differential VTE rates for procedural groups within each subspecialty were observed. The procedural groups with the highest VTE rates were free tissue transfer (6.1%), lateral skull base surgeries (4.4%), cricopharyngeal myotomies (3.1%), and anterior skull base surgeries (3.1%). Prior VTE (OR 12.3 [95% confidence interval, 11.2-13.4]) was the covariate with the highest risk for postoperative VTE.
CONCLUSION: Although the overall VTE rate was low (0.6%), intersubspecialty and intrasubspecialty variation in VTE rates were observed, and a subset of OHNS procedures had substantially higher VTE risk. These findings may inform surgeon decision-making regarding chemoprophylaxis.