Summary

We investigated age- and sex-specific incidence, risk factors,and latency period of a perioperative acute thromboembolismsyndrome (PATS) in a large cohort study. We prospectively analyzeddata on 21903 consecutive surgery patients to determinethe incidence of myocardial infarction, pulmonary embolism,deep venous thrombosis, stroke, and cardiovascular death within30 postoperative days. Among 255 (1.2 percent) patientswith thromboembolism, 105 (0.48 percent) suffered myocardialinfarction (mean latency: 5 days), 30 (0.14 percent) suffered pulmonaryembolism (6 days), 23 (0.11 percent) suffered deepvenous thrombosis (10 days), 97 (0.44 percent) suffered stroke(11 days), and 13 (0.06 percent) died (12 days).The critical periodwas postoperative week 1 for myocardial infarction andpulmonary embolism, and postoperative week 1 and 2 for deepvenous thrombosis, stroke, and death. Risk of all events increased with age (P<0.0001), particularly for over 70 years(odds ratio: 12.5; 95 percent confidence interval, 7.8 to 19.9).Males had an increased risk (P<0.0001) of myocardial infarction(odds ratio; 1.5; 95 percent confidence interval, 1.0 to 2.3).Females had an increased risk (P<0.0001) of pulmonary embolism(odds ratio: 2.7; 95 percent confidence interval, 1.3 to 5.9)and deep venous thrombosis (odds ratio: 9.8; 95 percent confidenceinterval, 3.3 to 29.3). Risk of thromboembolic event washigher (P<0.0001) in patients with a history of arterial thromboticevents or cancer. Trend analysis indicates that thromboembolicevents will increase 3-fold over the next decade.Our findings enable identification of higher risk patients forprophylactic anti-thromboembolic treatment and awareness ofthe critical postoperative period.