A novel risk assessment model for venous thromboembolism after major thoracic surgery: a Chinese single-center study

Tian, Bo; Li, Hui; Cui, Songping; Song, Chun; Li, Tong; Hu, Bin

doi:10.21037/jtd.2019.05.11

Cited by 26 publications

(21 citation statements)

References 26 publications

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“…17 This has led to an increased interest in determining the applicability of KS for cancer patients undergoing surgical procedures, for example, lung cancer. 18,19 In the current study, patients with higher risk KS had pT 3 disease or higher more frequently, longer hospital stay, and received blood transfusion more frequently. Although locally advanced disease, longer inpatient stay and perioperative blood transfusion are well-established risk factors for VTE, 20,21 there was no statistically significant difference in the prevalence of VTE between the two groups.…”

Section: Resultsmentioning

confidence: 52%

Validation of the Khorana Score for Prediction of Venous Thromboembolism After Robot-Assisted Radical Cystectomy

Iqbal

Elsayed

Ozair

et al. 2021

Journal of Endourology

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Introduction: The Khorana score (KS) is used to predict the risk of venous thromboembolism (VTE) for cancer patients. We sought to assess the association between KS and VTE for patients who underwent robot-assisted radical cystectomy (RARC). Materials and Methods: We reviewed our prospectively maintained quality assurance RARC database between 2005 and 2020. KS was calculated for all patients (one point for each body mass index [BMI] ‡35 kg/m 2 , platelet count ‡350 • 10 9 /L, leukocyte count >11 • 10 9 /L, and hemoglobin level <10 g/dL, or use of erythropoiesisstimulating agents). All patients received one point by default for the cancer type (bladder). Patients were divided into intermediate-risk (KS 1-2) or high-risk (KS ‡3) groups. Receiver operating characteristic curve was used to assess the ability of KS to predict VTE. Kaplan-Meier curves were stratified based on their KS risk and used to depict overall survival (OS). Multivariate analysis (MVA) was used to identify variables associated with VTE. Results: Out of 589 patients, 33 (6%) developed VTE (18 had deep vein thrombosis and 15 had pulmonary embolism). Five hundred forty-six (93%) patients had intermediate-risk KS and 30 (5%) of them developed VTE. Forty-three (7%) patients were classified as high-risk KS and 3 (7%) developed VTE. This difference was not significant ( p = 0.73). The KS area under the curve for VTE prediction was 0.51. On MVA, BMI ‡35 kg/m 2 (odds ratio [OR] 2.69, confidence interval [CI] 1.19-6.11, p = 0.02), longer inpatient stay (OR 1.04, CI 1.003-1.07, p = 0.03), and ‡pT 3 disease (OR 2.29,, p = 0.03) were associated with VTE, whereas KS was not associated with VTE ( p = 0.68). Five-year OS of patients with intermediate KS was 53% compared with 30% for high-risk KS (log rank p < 0.01). Conclusion: KS underestimated VTE risk after RARC and showed poor accuracy. This highlights the need to develop procedure-specific tools to estimate the risk of VTE after RARC.

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Section: Resultsmentioning

confidence: 52%

Validation of the Khorana Score for Prediction of Venous Thromboembolism After Robot-Assisted Radical Cystectomy

Iqbal

Elsayed

Ozair

et al. 2021

Journal of Endourology

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“…However, higher VTE incidence rates (8.4%), were reported in major thoracic surgery in Chinese patients. 28 …”

Section: Discussionmentioning

confidence: 99%

<p>Venous Thromboembolism Risk and Thromboprophylaxis Assessment in Surgical Patients Based on Caprini Risk Assessment Model</p>

Tadesse¹,

Kedir²,

Fentie³

et al. 2020

RMHP

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Purpose Venous thromboembolism (VTE) is the most common preventable cause of hospitalization-associated mortality. In the absence of optimal prophylaxis and depending on the type of surgery and patient-related factors, the risk of developing VTE increases by 10% to 50%. We aimed to assess VTE risk and thromboprophylaxis among surgical patients hospitalized at surgical wards of Tikur Anbessa Specialized Hospital (TASH). Addis Ababa, Ethiopia. Materials and Methods A retrospective cross-sectional study was conducted from September 1, 2018 to February 28, 2019. Data were collected using a pretested observational checklist which is prepared based on the VTE Caprini risk assessment model. Then, the collected data were checked for completeness and finally entered and analyzed using Statistical Package for Social Sciences (SPSS) version 25. Results Out of 155 admitted patients, almost equal numbers of males (49.68%) and females (50.32%) participated in the study with a mean age of 41.87±16.84 and an age range of 13 to 89 years. Undergoing major surgery, resting in bed for more than 3 days and having acute infections (including pneumonia) were the most frequently seen VTE risk factors. Most of the study participants (135, 87.10%) were at risk of developing VTE (>1 Caprini risk score), and 47.11% were in the highest risk category (≥5 Caprini score). The maximum and minimum total risk scores were 19 and 1, respectively with a mean score of 4.53±2.31. Among patients who were at risk of developing VTE and eligible for thromboprophylaxis, only 17.78% received thromboprophylaxis and two ineligible patients received prophylaxis. Parental unfractionated heparin twice or three times per day was the most widely used thromboprophylaxis regimen. A total of 29 (18.71%) patients had one or more contraindication(s) for thromboprophylaxis and three of them took prophylaxis despite the contraindications. Only 3 (1.93%) patients admitted to surgical wards developed VTE during hospitalization. Conclusion As per the Caprini risk assessment model, the majority of surgical patients treated at TASH were at risk of developing VTE. However, thromboprophylaxis was underutilized. The incidence of VTE was 1.93% in our study.

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“…These types of operations are characterized by long operation time, a large amount of blood loss, need for blood transfusion, and the need to be performed under general anesthesia, and all of these parameters contribute to the risk of venous thrombosis formation 29,30 . At present, clinical researchers in different surgical specialties, including general surgery 31 , orthopedics 32 , thoracic surgery 33 , urology 34 , tumor surgery 35 and neurosurgery 36 , found that the incidence of VTE after major surgery is relatively high, ranging from 3.6% 31 to 21.3% 36 . They believe that major surgery is a risk factor for VTE and that active prevention is needed 8 .…”

Section: Discussionmentioning

confidence: 99%

Disease-Related Risk Factors for CVC-Related Symptomatic Thrombosis in Surgical ICU Inpatients

Liu

Zhu

Kuang

et al. 2020

Preprint

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To report the rate of symptomatic catheter-related venous thrombosis (CRVT) in surgical intensive care unit patients receiving central venous catheters (CVC) and analyze the disease-related risk factors for symptomatic CRVT in SICU patients. A retrospective analysis was performed on 1643 critically ill patients admitted to the SICU from January 2015 to December 2019. Cases were divided into two groups based on the presence of symptomatic CRVT, and the variables of interest were extracted from the electronic medical record system. Logistic univariate and multivariate regression analyses were used to determine the risk factors of SCRVT. A total of 209 symptomatic CRVT events occurred among 2114 catheters. Multivariate analysis showed that trauma (odds ratio [OR], 2.046; 95% confidence interval [CI] [1.325-3.160], P = 0.001), major surgery (OR, 2.457; 95% CI [1.641-3.679], P = 0.000), and heart failure (OR, 2.087; 95% CI [1.401-3.111], P = 0.000) were independent risk factors for symptomatic CRVT in SICU. The AUROC for this model was 0.610 (95% CI [0.569-0.651], P=0.000). The incidence rate was 9.89%. For patients hospitalized in the SICU, especially those admitted with these three conditions, thromboprophylaxis and/or mechanical prophylaxis should be actively provided to reduce the occurrence of symptomatic CRVT.

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A novel risk assessment model for venous thromboembolism after major thoracic surgery: a Chinese single-center study

Cited by 26 publications

References 26 publications

Validation of the Khorana Score for Prediction of Venous Thromboembolism After Robot-Assisted Radical Cystectomy

Validation of the Khorana Score for Prediction of Venous Thromboembolism After Robot-Assisted Radical Cystectomy

<p>Venous Thromboembolism Risk and Thromboprophylaxis Assessment in Surgical Patients Based on Caprini Risk Assessment Model</p>

Disease-Related Risk Factors for CVC-Related Symptomatic Thrombosis in Surgical ICU Inpatients

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