Racial differences in symptomatic postoperative venous thromboembolism rates after major oncologic resection

Background: Recent evidence suggests an increased incidence of venous thromboembolism among cancer patients of Black race. This study aimed to determine whether Black patients undergoing major oncologic resection experience increased rates of postoperative venous thromboembolism. Methods: A cohort study of patients who underwent major oncologic resection was performed using American College of Surgeons National Surgical Quality Improvement Program (2016−2018). Primary outcome was venous thromboembolism within 30 days of surgery. Multivariable logistic regression was performed to evaluate the independent association of race and venous thromboembolism. Results: Of 91,707 patients, 67.7% were White, 9.5% Black, and 22.9% other race. Venous thromboembolism rates differed slightly by race: 2.2% among Whites, 2.4% Blacks, and 1.8% other (P = .002). Black patients were older, with higher rates of obesity, diabetes, and smoking. By multivariable logistic regression, risk of venous thromboembolism was lower among patients of other compared with White race (odds ratio 0.83; 95% confidence interval, 0.74–0.94). There was no difference in odds of venous thromboembolism among Black relative to White patients (odds ratio 1.08; 95% confidence interval, 0.93–1.26). When stratified by age, rates of venous thromboembolism were >50% higher among Black patients older than 75 years compared with White patients (odds ratio 1.54; 95% confidence interval, 1.17–2.03). Conclusion: Despite evidence that Black patients with cancer experience higher rates of venous thromboembolism, they do not appear to have an increased risk in the postoperative period.