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Nwagha T, Nweke M. Stratification of Risk Factors of Lung Cancer-Associated Venous Thromboembolism and Determining the Critical Point for Preemptive Intervention: A Systematic Review With Meta-analysis. Clin Med Insights Oncol 2023; 17:11795549231175221. [PMID: 37426681 PMCID: PMC10328178 DOI: 10.1177/11795549231175221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/20/2023] [Indexed: 07/11/2023] Open
Abstract
Background Several biomarkers or risk factors have been identified and several prediction models exist. The major limitations inherent in these models include cost-ineffectiveness and lack of systematic stratification of risk factors resulting in the inclusion of clinically insignificant biomarkers in the models. This review aimed to systematically stratify the risk factors of lung cancer-associated venous thromboembolism (VTE) and determine the critical point for preemptive intervention. Methods This systematic review was structured as per the Preferred Reporting Item for Systematic Reviews and Meta-analyses. We searched MEDLINE, PubMed, Cochrane Library, CINAHL, Academic Search Complete, and PsycINFO from the onset to June 2022. We included studies that reported the risk factors of lung cancer-associated VTE and corresponding risk estimates, irrespective of treatment status but studies were excluded if patients were on anti-VTE medications. We employed random effects models of meta-analysis and computed risk stability index and risk weight (Rw) to achieve the review objectives. The review protocol is registered with PROSPERO (CRD42022336476). Results The clinically significant risk factors of VTE in lung cancer patients were D-dimer (odds ratio [OR] = 5.510, 95% CI = 2.6-11.7; Rw = 5.0), albumin (OR = 2.2, 95% CI = 1.0-4.8; Rw = 1.79), leukocyte (OR = 2.48, 95% CI = 1.9-3.2; Rw = 1.77), histological type (OR = 1.69 , 95% CI = 1.2-2.4; Rw = 1.3), age (OR = 1.56; Rw = 0.99), and hemoglobin (OR = 1.85, 95% CI = 1.3-2.6; Rw = 0.92). Based on the distribution of Rw across risk factors, the critical point (upper third of the upper quartile class) was 4.5 and may mark the point at which preemptive intervention should be commenced. Conclusions Targeted screening for VTE in lung cancer patients could be patient-specific and should be based on a combination of the most significant risk factors required to meet the critical point, provided that such a combination is affordable as illustrated in the ALBAH model. Registration The review protocol is registered with PROSPERO (ID: CRD42022336476).
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Affiliation(s)
- Theresa Nwagha
- Department of Haematology and
Immunology, Faculty of Medicine, University of Nigeria Teaching Hospital
Ituku-Ozalla, Enugu, Nigeria
| | - Martins Nweke
- Department of Physiotherapy, Evangel
University, Akaeze, Nigeria
- Fledgelight Evidence Consult, Enugu,
Nigeria
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Zhang Q, Zhang X, Zhang J, Jiang M, Zhang Y, Zheng D, Wu L, Wang W, Wang B, Wang Y. Genetic association and causal inference between lung function and venous thromboembolism. Respir Res 2023; 24:36. [PMID: 36717884 PMCID: PMC9885683 DOI: 10.1186/s12931-023-02335-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 01/18/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Previous studies have indicated that lower lung function is related to a higher risk of venous thromboembolism (VTE). However, causal inferences may be affected by confounders, coheritability or reverse causality. We aimed to explore the causal association between lung function and VTE. METHODS Summary data from public genome-wide association studies (GWAS) for lung function and VTE were obtained from published meta-analysis studies and the FinnGen consortium, respectively. Independent genetic variables significantly related to exposure were filtered as proxy instruments. We adopted linkage disequilibrium score regression (LDSC) and two-sample Mendelian randomization (MR) analyses to infer the genetic backgrounds and causal associations between different lung functions and VTE events. RESULTS LDSC showed a genetic correlation between forced expiratory volume in one second (FEV1) and deep vein thrombosis (DVT) (rg = - 0.189, P = 0.005). In univariate MR (UVMR), there was suggestive evidence for causal associations of genetically predicted force vital capacity (FVC) with DVT (odds ratio (OR) 0.774; 95% confidence interval (CI) 0.641-0.934) via forwards analysis and genetically predicted pulmonary embolism (PE) with FVC (OR 0.989; 95% CI 0.979-0.999) via reverse analysis. Multivariate MR (MVMR) analyses of lung function-specific SNPs suggested no significant direct effects of lung function on VTE, and vice versa. Of note is the borderline causal effect of PE on FEV1 (OR 0.921; 95% CI 0.848-1.000). CONCLUSIONS Our findings identified a coheritability of FEV1 (significant) and FVC (suggestive) with DVT. There was no convincing causal relationship between lung function and the risk of VTE events. The borderline causal effect of PE on FEV1 and the significant genetic correlation of FEV1 with DVT may have clinical implications for improving the quality of existing prevention and intervention strategies.
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Affiliation(s)
- Qiaoyun Zhang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China ,grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Xiaoyu Zhang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China ,grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Jie Zhang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China
| | - Mengyang Jiang
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Yiqiang Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Deqiang Zheng
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China
| | - Lijuan Wu
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China
| | - Wei Wang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China ,grid.1038.a0000 0004 0389 4302Centre for Precision Medicine, Edith Cowan University, Joondalup, WA Australia
| | - Baoguo Wang
- grid.24696.3f0000 0004 0369 153XDepartment of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, 50 Yikesong Road, Haidian District, Beijing, 100093 China
| | - Youxin Wang
- grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, No. 10 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, 100069 China ,grid.1038.a0000 0004 0389 4302Centre for Precision Medicine, Edith Cowan University, Joondalup, WA Australia
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Li Y, Shen L, Ding J, Xie D, Yang J, Zhao Y, Carretta A, Petersen RH, Gilbert S, Hida Y, Bölükbas S, Fernando HC, Jiang G, Zhu Y. Derivation and validation of a nomogram model for pulmonary thromboembolism in patients undergoing lung cancer surgery. Transl Lung Cancer Res 2021; 10:1829-1840. [PMID: 34012796 PMCID: PMC8107740 DOI: 10.21037/tlcr-21-109] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background A specific risk-stratification tool is needed to facilitate safe and cost-effective approaches to the prophylaxis of acute pulmonary thromboembolism (PTE) in lung cancer surgery patients. This study aimed to develop and validate a simple nomogram model for the prediction of PTE after lung cancer surgery using readily obtainable clinical characteristics. Methods A total of 14,427 consecutive adult patients who underwent lung cancer surgery between January 2015 and July 2018 in our institution were retrospectively reviewed. Included in the cohort were 136 patients who developed PTE and 544 non-PTE patients. The patients were randomly divided into the derivation group (70%, 95 PTE patients and 380 non-PTE patients) and the validation group (30%, 41 PTE patients and 164 non-PTE patients). A nomogram model was developed based on the results of multivariate logistic analysis in the derivation group. The cut-off values were defined using Youden's index. The prognostic accuracy was measured by area under the curve (AUC) values. Results In the derivation group, multivariate logistic analysis was carried out to evaluate the risk score. The risk assessment model contained five variables: age [95% confidence interval (CI): 1.008-1.083, P=0.016], body mass index (95% CI: 1.077-1.319, P=0.001), operation time (95% CI: 1.002-1.014, P=0.008), the serum level of cancer antigen 15-3 (CA15-3) before surgery (95% CI: 1.019-1.111, P=0.005), and the abnormal results of compression venous ultrasonography before surgery (95% CI: 2.819-18.838, P<0.001). All of them were independent risk factors of PTE. To simplify the risk assessment model, a nomogram model was established, which showed a good predictive performance in the derivation group (AUC 0.792, 95% CI: 0.734-0.853) and in the validation group (AUC 0.813, 95% CI: 0.737-0.890). Conclusions A high-performance nomogram was established on the risk factors for PTE in patients undergoing lung cancer surgery. The nomogram could be used to provide an individual risk assessment and guide prophylaxis decisions for patients. Further external validation of the model is needed in lung cancer surgery patients in other clinical centers.
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Affiliation(s)
- Yuping Li
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Shen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Junrong Ding
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Dong Xie
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jian Yang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yanfeng Zhao
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Angelo Carretta
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan, Italy
| | - René Horsleben Petersen
- Department of Cardiothoracic Surgery, University Hospital of Copenhagen-Rigshospitalet, Copenhagen, Denmark
| | - Sebastien Gilbert
- Division of Thoracic Surgery, Department of Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | - Yasuhiro Hida
- Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Servet Bölükbas
- Department of Thoracic Surgery, Kliniken Essen-Mitte, Essen, Germany
| | - Hiran C Fernando
- Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yuming Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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Risk factors of deep vein thrombosis of lower extremity in patients undergone gynecological laparoscopic surgery: what should we care. BMC WOMENS HEALTH 2021; 21:130. [PMID: 33771148 PMCID: PMC8004430 DOI: 10.1186/s12905-021-01276-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/10/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Deep vein thrombosis (DVT) significantly influences the prognosis of patients. It's necessary to analyze the risk factors for postoperative DVT in patients undergone gynecological laparoscopic surgery. METHODS Patients who underwent gynecological laparoscopic surgery from January 1, 2018 to May 31, 2020 were included. The characteristics and clinical data of DVT and non DVT patients were collected and analyzed. Logistic regression analysis was performed to identify the risk factors of DVT in patients undergone gynecological laparoscopic surgery. RESULTS A total of 355 patients undergone gynecological laparoscopic surgery were included, the incidence of postoperative DVT was 11.55%. There were significant differences in the age, hypertension, D-dimer, duration of surgery, intraoperative pneumoperitoneum pressure, duration of days in bed between DVT and non-DVT groups (all p < 0.05), and there were no significant difference in the BMI, diabetes, hyperlipidemia, ASA classification and intraoperative blood transfusion between DVT and non-DVT groups (all p > 0.05). Age > 50 years (OR 4.246, 95% CI 1.234-7.114), hypertension (OR 2.219, 95% CI 1.153-4.591), D-dimer > 0.5 mg/L (OR 3.914, 95% CI 1.083-5.229), duration of surgery ≥ 60 min (OR 2.542, 95% CI 1.101-4.723), intraoperative pneumoperitoneum pressure ≥ 15 mmHg (OR 3.845, 95% CI 1.119-5.218), duration of days in bed > 3 days (OR 1.566, 95% CI 1.182-1.994) was the independent risk factors for DVT in patients undergone gynecological laparoscopic surgery (all p < 0.05). CONCLUSIONS The incidence of postoperative DVT in patients undergone gynecological laparoscopic surgery is high, and those high-risk factors should be targeted to intervene in order to reduce the postoperative DVT.
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Shen L, Li Y, Ding J, Yang J, Jiang G, Sihoe ADL. Implementation of a pulmonary thromboembolism prophylaxis program in Chinese lung surgery patients: compliance and effectiveness. J Thorac Dis 2020; 12:4307-4314. [PMID: 32944343 PMCID: PMC7475573 DOI: 10.21037/jtd-20-690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Most studies on prophylaxis against pulmonary embolism (PE) after lung surgery have come from the West. Whether such prophylactic programs can be successfully developed in China has not been fully studied. Methods A prospective observational trial included 581 Chinese patients receiving lung resection surgery between August 8 and September 12 of 2017. The Caprini score was assessed on the first postoperative day (POD1). For PE prophylaxis, patients with a low score (0-4, n=55) received early ambulation, and those with a high score (≥5, n=526) received early ambulation combined with low-molecular weight heparin (LMWH) injection. PE incidence and the compliance with this protocol was recorded. Results Three patients (0.52%) developed PE and all 3 were in the high-risk group, but LMWH was not given (non-compliance). Within the non-compliance patients (n=275), the incidence of PE was 1.09%, higher than that in the compliance patients (0%). The rate of non-compliance with the program was 47.3% (275/581) in the entire cohort. The factors associated with non-compliance were: extended lobectomy performed (9.2% vs. 1.0%, P<0.001); higher volume of postoperative chest drainages (278 vs. 239 mL, P=0.028). The non-compliance group had longer duration of ICU stay (mean of 1.3 vs. 1.1 days, P<0.001); and longer overall hospital stay (mean of 9.7 vs. 8.5 days, P<0.001). Conclusions Developing a PE prophylaxis program for patients receiving lung surgery in China contributed to lowering the risk of PE. Failure of compliance in patients with high risk for PE after lung surgery may be linked to worse outcomes.
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Affiliation(s)
- Lei Shen
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Yuping Li
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Junrong Ding
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Jian Yang
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
| | - Gening Jiang
- Department of Thoracic Surgery, Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai, China
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Ke L, Cui S, Chen S, Hu B, Li H. Dynamics of D-dimer in non-small cell lung cancer patients receiving radical surgery and its association with postoperative venous thromboembolism. Thorac Cancer 2020; 11:2483-2492. [PMID: 32657038 PMCID: PMC7471045 DOI: 10.1111/1759-7714.13559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) occurs at a high rate after lung cancer surgery and can be attributed to various clinical risk factors. Here, we aimed to determine whether early detection of perioperative D-dimer and risk-stratified cutoff values would improve the diagnostic efficacy of VTE. METHODS In this case-control study, D-dimer results were acquired from 171 non-small cell lung cancer (NSCLC) patients preoperatively and at the first, third, and fifth day after surgery. VTE was confirmed by Doppler ultrasonography and computer tomography pulmonary angiography (CTPA). Repeated measures ANOVA was used to analyze how D-dimer changed with time and the effects of risk factors on D-dimer levels. We then compared sensitivity, specificity and negative predictive value, using both adjusted and unadjusted cutoff values. RESULTS VTE occurred in 23 patients (13.5%) of the study population. D-dimer levels increased unsustainably after lung cancer surgery (P < 0.001) due to a trough on the third day, and patients who had undergone thoracotomy (P < 0.001) and those at a more advanced tumor stage (P = 0.037) had higher D-dimer levels. Area under the curve of D-dimer was greatest on the third day (0.762 [P < 0.001, 95% CI: 0.643-0.882]). Applying stratified cutoff values improved the specificity in the video-assisted thoracoscopy surgery (VATS) (P = 0.004) and thoracotomy groups (P < 0.001). CONCLUSIONS D-dimer levels elevated with fluctuation in NSCLC patients after surgery. Surgical options and tumor stages had an impact on D-dimer levels. With regard to VTE diagnosis, stratified cutoff values by these two factors showed better accuracy compared with a collective one.. KEY POINTS SIGNIFICANT FINDINGS OF THE STUDY: The changing pattern of perioperative D-dimer levels in NSCLC patients who received surgical therapy in a major teaching hospital in Beijing, China was revealed. WHAT THIS STUDY ADDS Risk-stratified D-dimer cutoff values adjusted to surgical methods and disease stages would benefit the exclusion of postoperative venous thromboembolism.
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Affiliation(s)
- Lihui Ke
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Songping Cui
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Shuo Chen
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Bin Hu
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Wang P, Zhao H, Zhao Q, Ren F, Shi R, Liu X, Liu J, Liu H, Chen G, Chen J. Risk Factors and Clinical Significance of D-Dimer in the Development of Postoperative Venous Thrombosis in Patients with Lung Tumor. Cancer Manag Res 2020; 12:5169-5179. [PMID: 32636679 PMCID: PMC7335272 DOI: 10.2147/cmar.s256484] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/26/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The incidence of venous thromboembolism (VTE) is higher in patients with lung cancer. The aim of this study was to investigate the risk factors associated with postoperative VTE and explore the VTE predication capacity of D-dimer kinetics. PATIENTS AND METHODS Six hundred patients who had lung tumor surgery were analyzed retrospectively between January 2018 and August 2019, and venous ultrasound imaging and D-dimer examination before and after surgery were recommended to all operative patients. Of these 600 patients, 523 patients had venous thromboembolism after surgery, and 77 patients had not found. The general clinical data, postoperative prophylactic anticoagulant therapy, early systemic thromboprophylaxis, 50% increment of D-dimer, 100% increment of D-dimer, and perioperative (preoperative and days 1, 3, and 5 after surgery) D-dimer levels were collected. Logistic regression analysis was used to analyze the independent risk factors of postoperative VTE. RESULTS VTE developed in 77 (12.8%) patients. In a univariate analysis, age, surgical approach, tumor size, histology, postoperative preventive anticoagulation, postoperative limb compression therapy, postoperative hemostasis, duration of operation, early systemic thromboprophylaxis, 100% increment of D-dimer, preoperative and postoperative D-dimer level, intraoperative blood loss, and time spent in the hospital were significantly different between the thrombus group and nonthrombus group (P < 0.05). Multivariate analysis showed that age >60 years (P = 0.006) and D-dimer level on 5 days after surgery (P = 0.000) were significant independent risk factors for VTE. Postoperative D-dimer was significantly higher than the preoperative level (P < 0.001). Postoperative D-dimer level was significantly different between benign and malignant tumor groups (P < 0.05) and between the thrombus group and nonthrombus group (P < 0.001). Preventive anticoagulation and limb compression therapy starting from the first day after surgery was statistically significant between the thrombus group and the nonthrombus group (P < 0.05). CONCLUSION Continuous detection of D-dimer level after pulmonary tumor surgery combined with thrombotic-related risk factors can better evaluate the occurrence of VTE. Preventive anticoagulant therapy and limb compression therapy starting from the first day after surgery can effectively reduce the incidence of VTE.
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Affiliation(s)
- Pan Wang
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Honglin Zhao
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Qingchun Zhao
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Fan Ren
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Ruifeng Shi
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Xingyu Liu
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Jinghao Liu
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Hongyu Liu
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Gang Chen
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
| | - Jun Chen
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
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Li L, Li H. [Perioperative Venous Thromboembolism (VTE) Prophylaxis in Thoracic Cancer Patients: Chinese Experts Consensus - Interpretation of Screening of High-risk Patients]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2020; 22:747-751. [PMID: 31874668 PMCID: PMC6935039 DOI: 10.3779/j.issn.1009-3419.2019.12.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
静脉血栓栓塞症(venous thromboembolism, VTE)是胸部恶性肿瘤患者围术期较常见的一种并发症,一旦发生,不但影响患者预后,还将占用大量医疗资源,这正逐步引起我们的广泛重视。然而,我国胸外科对于VTE的认识起步较晚,认知度和重视度亦不够,且目前尚缺少针对围术期VTE预防的指南支持。基于目前我国胸外科对于VTE的认识及预防措施现状,中国胸外科静脉血栓栓塞研究协作组发布了国际首部《胸部恶性肿瘤围术期静脉血栓栓塞症预防中国专家共识(2018版)》。本文将对其中胸部恶性肿瘤患者围术期VTE的高危患者筛查进行解读,以便于更好地理解共识相关内容。
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Affiliation(s)
- Lihong Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Sun Y, Li H. [Perioperative Venous Thromboembolism (VTE) Prophylaxis in Thoracic Cancer Patients: Chinese Experts Consensus - Interpretation of Epidemiological Characteristics]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2019; 22:741-746. [PMID: 31874667 PMCID: PMC6935037 DOI: 10.3779/j.issn.1009-3419.2019.12.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
胸部恶性肿瘤患者围术期静脉血栓栓塞症(venous thromboembolism, VTE)是一种需要引起重视的胸外科围术期并发症,中国胸外科静脉血栓栓塞研究协作组针对胸部恶性肿瘤患者围术期VTE的预防,发布了国际首部《胸部恶性肿瘤围术期静脉血栓栓塞症预防中国专家共识》(2018版)。本文将对其中胸部恶性肿瘤围术期VTE的流行病学特征、国内外面临的挑战及预防现状进行解读,以助于更好地理解共识相关内容。
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Affiliation(s)
- Yixin Sun
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hui Li
- Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
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Wang X, Song S, Ni R, Lu M, Mao Y. Effectiveness of intraoperative administration of intermittent pneumatic compression in preventing deep vein thrombosis in lung cancer patients undergoing video-assisted thoracoscopic surgery lobectomy. J Thorac Dis 2019; 11:2832-2838. [PMID: 31463112 DOI: 10.21037/jtd.2019.07.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background This study aimed to determine the effectiveness of intermittent pneumatic compression (IPC) in the prevention of deep vein thrombosis (DVT) in lung cancer patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy. Methods This study included 495 lung cancer patients undergoing VATS from March 2018 to November 2018. Patients were randomly assigned to an IPC group or a control group using sealed envelopes containing a slip indicating the allocation. IPC calf sleeves were applied to both legs during the surgery. All patients were subjected to D-dimer and echo color-Doppler detection pre- and postoperatively. The incidences of DVT were compared between the two groups. Results While D-dimer levels failed to show any significant difference between the two groups, the incidence of DVT showed significant difference with respect to the ultrasonographic features of the thrombi. Intraoperative administration of IPC significantly reduced the risk of DVT compared with no mechanical prophylaxis (P<0.0001). No complications related to IPC occurred. Conclusions Intraoperative administration of IPC was effective in preventing postoperative DVT in lung cancer patients undergoing VATS.
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Affiliation(s)
- Xiaojun Wang
- Department of Operating Room, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Saiqi Song
- Department of Operating Room, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Ruijie Ni
- Department of Operating Room, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Min Lu
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Yanjun Mao
- Department of Nursing, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
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