Analysis of risk factors for deep venous thrombosis in patients with gynecological malignant tumor: A clinical study

Xue, Yinling; Yuan, Ping; Li, Lin

doi:10.12669/pjms.35.1.365

Cited by 12 publications

(11 citation statements)

References 17 publications

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“…Regarding malignancy, patients who received gynecologic cancer surgery were considered to be at high risk of DVT due to advanced age, cancer type, presence of pro-thrombotic mutations, pelvic mass compressing the major pelvic veins, endothelial cell injury during pelvic lymphadenectomy, lengthy surgical procedures, and thrombogenic chemotherapy [ 17 , 18 ]. In the present study, five from six patients were diagnosed with a malignancy.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factor of post-operative lower extremities deep vein thrombosis in patients undergoing gynecologic surgery: a single-institute cross-sectional study

et al. 2022

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Background and aim The study of prevalence and risk factors of postoperative lower limb deep vein thrombosis (DVT) in Thai gynecologic patients was limited. The present study was conducted to evaluate this issue. Methods The patients were age > 15 years old without a history of DVT or pulmonary emboli (PE) scheduled for laparotomy or vaginal gynecologic surgery between May and November 2020 were invited to participate. All of these patients were scheduled for a complete duplex ultrasound to detect lower limb DVT 72 h before and within 14 days after the operation. The patients without DVT were scheduled for an interview by telephone about DVT symptoms 30 days after the operation. The clinical variables were compared using univariate and multivariate analysis to identify the independent factors related to the development of DVT. Results One hundred and twelve patients met the inclusion criteria. Of these patients, 44 cases (39.3%) were diagnosed as malignancy and 102 patients underwent a hysterectomy. Post-operative DVTs were detected in six patients (5.4%) and all except one had a malignancy. Thus, the prevalence of DVT in malignancy cases was five in 44 patients (11.4%). The independent risk factors for postoperative DVT were age > 60-year-old and receiving a perioperative blood transfusion. Five of six DVT patients received low molecular-weight heparin for treatment of DVT and none developed PE. The rest of the participants reported no symptom-related DVTs from the interview 30 days after the operation. Conclusion The prevalence of postoperative DVT in gynecologic patients was 5%, and the independent risk factors were elderly patients and receiving a perioperative blood transfusion.

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Section: Discussionmentioning

confidence: 99%

Prevalence and risk factor of post-operative lower extremities deep vein thrombosis in patients undergoing gynecologic surgery: a single-institute cross-sectional study

et al. 2022

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“…However, in certain populations, hypertension showed a strong influence on DVT. Li Qun et al [ 21 ] explored the risk factors of DVT in patients with gynecological malignancies and found that hypertension was one of the independent influencing factors (OR = 2.638, 95% CI: 1.523–4.539, P < 0.0001). A meta-analysis conducted by Ageno et al [ 22 ] found that the VTE risk was increased in patients with classic cardiovascular disease risk factors, including obesity (OR = 2.3), high blood pressure (OR = 1.5), diabetes (OR = 1.4), and hyperlipidemia (OR = 1.2).…”

Section: Discussionmentioning

confidence: 99%

“…Radiochemotherapy is a common treatment for gynecological tumors. It has been reported that radiotherapy is an independent risk factor for thrombosis in patients with tumor [ 21 ]. Recording radiotherapy-related information and analyzing the risk of thrombosis can help prevent thrombosis and improve the quality of life of patients receiving radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Correlation between serum factor VIII:C levels and deep vein thrombosis following gynecological surgery

et al. 2021

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Deep vein thrombosis (DVT) is common in patients following gynecological surgery. Coagulation factor VIII (FVIII) is an important part of the human coagulation system, and FVIII:C is a component of FVIII with anticoagulant activity. 800 patients who underwent gynecological surgery were enrolled. General clinical data were harvested, and pre – and postoperative serum FVIII levels were determined. Lower-extremity ultrasound examination and/or postoperative pulmonary angiography were performed. Related data were analyzed statistically. DVT was the first manifestation of venous thromboembolism in all cases. There were a total of 46 cases, and the incidence of DVT was 5.8%. Progression to pulmonary embolism was confirmed in 16 cases, with an incidence of 2.0%. The independent risk factors for DVT after gynecological surgery were postoperative FVIII:C levels (odds ratio [OR] = 1.01), age (OR = 6.57), and operation time ≥3 hours (OR = 2.90) ( P < 0.05). When the FVIII:C level was greater than the 75th centile (≥150 IU/dL), the risk of DVT was 2.99 times higher than that below the 25th centile (<100 IU/dL) ( P < 0.05). When combined with the risk factor of operation time ≥3 hours, the risk increased to 3.17 times ( P = 0.10). When combined with age ≥60 years, the risk was significantly increased, reaching 12.0 times ( P < 0.05). Serum FVIII:C levels are an independent risk factor for DVT after gynecological surgery. Higher levels increase the risk of DVT after gynecological surgery, and they may have a dose-dependent relationship. A synergistic effect exists in combination with other risk factors, which further increases the risk.

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“…Numerous studies have demonstrated that DVT is a complex multifactorial disease influenced by several risk factors, including surgery and trauma, prolonged immobilization, myeloproliferative disorders, pregnancy and postpartum status, weight, age, smoking status and corticosteroid treatment. [15][16][17] In addition, radiotherapy and cancer increase the risk of developing DVT, [18][19][20] and the reported cumulative incidence of venous thrombosis in cancer patients is 1-8%. 21 Moreover, after radiotherapy, changes in the structure of the pelvic tissue, the blood composition and the vessel wall are more rapid than those of fibrosis, 22,23 and radionecrosis and granulation of the small lymphatic vessels, lymph nodes, and soft tissue around vessels following radiotherapy can lead to the accumulation of protein-rich fluid in soft tissues secondary to inadequate lymphatic drainage.…”

Section: Introductionmentioning

confidence: 99%

Risk Prediction and Treatment of LE-DVT in Patients with Chronic Radiation Intestinal Injury: A Retrospective Case–Control Study

Huang

Kuang

Qin

et al. 2021

CMAR

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Background Chronic radiation intestinal injury (CRII) is the most common complication after pelvic malignancy radiation. Once hemorrhagic CRII patients suffer from lower extremity deep venous thrombosis (LE-DVT), hemostasis and anticoagulation therapy will be adopted simultaneously, but the treatment strategy is a paradox, as the condition is extremely intractable and serious. The aim of this study was to investigate the prevalence of and risk factors for LE-DVT in CRII patients and explore the treatment of hemorrhagic CRII patients with LE-DVT. Methods This was a retrospective study, and a total of 608 hospitalized CRII patients after pelvic radiotherapy were included from November 2011 to October 2018. Univariate and multivariate analyses were conducted to investigate the potential risk factors for LE-DVT in CRII patients. Furthermore, the treatment of hemorrhagic CRII patients with LE-DVT was explored. Results Among the CRII patients, 94 (15.5%) were with suspicious symptoms of LE-DVT in the lower limbs, and 32 (5.3%) were diagnosed with LE-DVT. Among the patients with LE-DVT, 65.6% (21/32) had bleeding simultaneously, and 29 (90.6%) had anemia with 24 (75.0%) having moderate to severe anemia. Multivariate analysis showed that a recent surgical history (≤6 months) (OR = 5.761, 95% CI: 2.506~13.246, p < 0.001), tumor recurrence or metastasis (OR = 3.049, 95% CI: 1.398~6.648, p = 0.005) and the hemoglobin (Hb) level (OR = 0.960, 95% CI: 0.942~0.979, p < 0.001) were significantly associated with the development of LE-DVT. ROC curve analysis showed that the AUC of the merged risk score of the independent risk factors was 0.822 (95% CI: 0.789~0.852), and the optimal Hb cutoff was 82.5 g/L. After colostomy, obvious bleeding remission was rapidly found in 84.6% of hemorrhagic CRII patients with LE-DVT. Conclusion The prevalence of LE-DVT in hospitalized CRII patients was 5.3%. A recent surgical history, tumor recurrence or metastasis and a lower Hb level were independently associated with LE-DVT development in CRII patients. Colostomy could be a good choice for intractable hemorrhagic CRII patients with LE-DVT.

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Analysis of risk factors for deep venous thrombosis in patients with gynecological malignant tumor: A clinical study

Cited by 12 publications

References 17 publications

Prevalence and risk factor of post-operative lower extremities deep vein thrombosis in patients undergoing gynecologic surgery: a single-institute cross-sectional study

Prevalence and risk factor of post-operative lower extremities deep vein thrombosis in patients undergoing gynecologic surgery: a single-institute cross-sectional study

Correlation between serum factor VIII:C levels and deep vein thrombosis following gynecological surgery

Risk Prediction and Treatment of LE-DVT in Patients with Chronic Radiation Intestinal Injury: A Retrospective Case–Control Study

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