Increased Risk of Blood Clot in Patients with Head & Neck Cancer Not Receiving Anticoagulation Therapy

There is an increased risk of venous thromboembolism (VTE, blood clot) in patients with head and neck cancer who are hospitalized after surgery and who are not routinely receiving anticoagulation therapy, according to a study by Daniel R. Clayburgh, M.D., Ph.D., and colleagues from Oregon Health and Science University, Portland.

VTE is responsible for 5 percent to 10 percent of all hospital deaths, and surgical cancer patients are considered among the highest risk, according to the study background. Treatment with anticoagulants is commonly recommended after surgery, although in patients with head and neck cancer possible complications include bleeding and wound complications. Previous studies suggest that general otolaryngology patients are at low risk for VTE, so compliance with VTE prophylaxis (administering medication to prevent blood clots) has been low among head and neck surgeons, the authors write.

Researchers measured new cases of VTE within 30 days of surgery among patients hospitalized for at least four days, and found an overall incidence of VTE of 13 percent in a study of 100 patients who were hospitalized at a tertiary care academic medical center and underwent surgery to treat head and neck cancer..

The study also found that 14 percent of patients received some form of anticoagulation therapy and that bleeding complications in those patients were higher than in patients without anticoagulation therapy.

“Our results support the use of routine VTE chemoprophylaxis in patients with head and neck cancer admitted for more than 72 hours after surgery,” the study concludes.

JAMA Otolaryngol Head Neck Surg. Published online September 26, 2013. doi:10.1001/jamaoto.2013.4911.