Influence of Prescribed Blood Products on the Incidence of Deep Vein Thrombosis and Pulmonary Embolism in Surgical Patients

Abstract

Deep vein thrombosis (DVT) and pulmonary embolisms (PEs) are common complications after surgical procedures. The influence of prescribed blood products on the occurrence of DVT and PE was evaluated in postsurgical patients in this retrospective case-control study. The records of 286 surgical patients were analyzed: DVT (n = 52), PE (n = 92), and a control group (n = 142). The amounts of prescribed blood, blood products, and vitamin K were reviewed, together with appropriate prescribing of low-molecular-weight heparins. The influence of prescribed blood products on the occurrence of DVT or PE was analyzed using multinomial logistic regression. We demonstrated a significant difference between the test and control groups ( P < .05) in relation to receiving packed red blood cells. Treatment with red blood cells was associated with an increased risk of PE but not DVT. Patients who developed PE after surgery were hospitalized for longer (median 10 days) than patients with DVT (median 6 days). There was no difference between the test and control groups concerning treatment with fresh frozen plasma. Inadequate thromboprophylaxis significantly increased the likelihood of DVT. There is a connection between receiving packed red blood cells and occurrence of postoperative PE in surgical patients. Thus, patients receiving red blood cells should be monitored more closely after surgery, as they are more likely to develop PE postoperatively.

Thrombosis Risk in Cancer Patients Receiving Red Blood Cell Transfusions

“…Red blood cell transfusions have been associated with an increased risk of thrombosis in several settings, such as surgical patients, 59 surgical patients who could not be anticoagulated for medical reasons, 60 spine surgery, 61 subarachnoid hemorrhage, 62 and postpartum bleeding. 63 In trauma patients with massive transfusion, higher RBC usage was independently associated with higher VTE risk.…”

Clinical Effects and Possible Mechanisms of Transfusion-Related Immunomodulation

“…Most observational studies investigating VTE ignored the role of allogeneic blood transfusion as a causal factor. Few studies found in cancer and after surgery that blood transfusions were dosedependently associated with VTE [74][75][76]. One study in 1070 patients undergoing cardiac surgery found a dose-dependent association with transfusion of blood products and VTE [77].…”