Low-molecular-weight heparin usage after autologous breast reconstruction: a big data analysis

Purpose: Autologous breast reconstruction is associated with an increased risk of venous thromboembolism, and low-molecular-weight heparin (LMWH) is frequently used for prophylaxis. Since the National Health Insurance Service coverage for breast reconstruction was introduced in 2015, the Health Insurance Review and Assessment Service has collected nationwide data on breast reconstruction procedures. This study analyzed these data to evaluate the influence of LMWH use after autologous breast reconstruction.Methods: Data from patients who underwent autologous breast reconstruction between 2017 and 2020 were collected. Information on LMWH prescriptions was obtained, and demographic characteristics and postoperative complications were analyzed.Results: A total of 3,599 autologous breast reconstruction procedures were identified, and LMWH was administered to 477 patients. Venous thromboembolism occurred in 38 cases. The need for transfusion was significantly higher in the LMWH group (2.86% vs. 0.47%, p<0.001). Multivariate analysis of factors associated with venous thromboembolism demonstrated significant associations with age, body mass index, and axillary lymph node dissection; however, no prophylactic effect of LMWH was observed.Conclusion: Although a preventive effect of LMWH against venous thromboembolism could not be demonstrated in this analysis, the analytical methods have inherent limitations that warrant further methodological refinement in future studies.