One of the things doctors look for after surgery is the possibility of blood clots forming. Most cancer surgery patients have a high risk of blood clots. Head and neck cancer surgery patients were believed to be at low risk for blood clots. New research suggests otherwise.
Hospitalized patients who had undergone surgery for head and neck cancer had an increased risk of venous thromboembolism (VTE) — blood clots that can form anywhere in the body.
As a result of these findings, the authors suggested that head and neck cancer surgery patients should receive medications to prevent VTE.
Daniel R. Clayburgh, MD, PhD, and colleagues from Oregon Health and Science University in Portland, Oregon conducted this study to determine the incidence of postoperative VTE in patients with head and neck cancer.
VTE affects about 600,000 hospitalized patients in the US every year, according to the study’s introduction.
The risks of blood clotting are twice as high in cancer patients compared to patients without the disease, and VTE may be the most common cause of death among cancer patients who’ve recently undergone surgery, the authors noted.
Previous studies have found that general otolaryngology (ear, nose and throat) surgical patients have low VTE risks, so giving medications to prevent blood clots has been low.
“Patients undergoing head and neck cancer surgery are at increased risk for development of VTE compared with general otolaryngology patients for several reasons, including older age, tobacco use, major surgery, decreased mobility, and decreased pulmonary [lung] function,” the authors wrote.
For this study, 100 head and neck cancer patients were examined for blood clots on the second or third day after surgery. An ultrasound examination was used to look for blood clots in the legs, which is a common area for VTE to start.
The researchers evaluated the number of new VTE cases within 30 days of surgery and found that 13 percent of the study participants who had been hospitalized for at least four days had developed blood clots.
Further, the study found that 14 percent of the patients had received some type of blood thinning (anticoagulant) therapy and that bleeding complications were higher in these patients than those who had received no anticoagulant therapy.
Head and neck cancer patients who have undergone surgery and will be hospitalized for more than 72 hours should receive medications to prevent VTE, the authors concluded.
This study was published September 26 in JAMA Otolaryngology-Head & Neck Surgery.
No outside funding sources were named, and none of the authors reported potential conflicts of interest.