Risk Factors and Anticoagulation Therapy in Patients With Isolated Distal Deep Vein Thrombosis in the Early Post-operative Period After Thoracic Surgery

Li, Yuping; Ding, Junrong; Shen, Lei; Yang, Jian; Wang, Haifeng; Zhou, Yiming; Jiang, Gening; Zhu, Yuming; Yin, Wang

doi:10.3389/fsurg.2021.671165

Cited by 3 publications

(3 citation statements)

References 62 publications

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“…Age was found to be an independent risk factor. Related studies have shown that the frequency of distal DVT in women is higher than that in men [ 25 , 43 , 44 ], which is consistent with the findings of this research that sex is an independent risk factor for ICMVT.…”

Section: Discussionsupporting

confidence: 93%

Generation of a Predictive Clinical Model for Isolated Distal Deep Vein Thrombosis (ICMVT) Detection

Xu,

Zheng

et al. 2023

Med Sci Monit

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Background Isolated distal deep vein thrombosis (ICMVT) increases the risk of pulmonary embolism. Although predictive models are available, their utility in predicting the risk is unknown. To develop a clinical prediction model for isolated distal calf muscle venous thrombosis, data from 462 patients were used to assess the independent risk variables for ICMVT. Material/Methods The area under curve (AUC) for Model A and Model B were calculated and other risk factors were based on age, pitting edema in the symptomatic leg, calf swelling with least 3 cm larger than the asymptomatic leg, recent bed rest for 3 days or more in the past 4 weeks, requiring general or major surgery with regional anesthesia, sex, and local tenderness distributed along the deep venous system as independent predictors of calf muscle venous thrombosis. Model A includes the risk variables for C-reactive protein and D-dimer. Results The area under ROC curve for Model A training set was 0.924 (95% CI: 0.895–0.952), the area under ROC curve for Model B training set was 0.887 (95% CI: 0.852–0.922), and the AUC difference between the 2 models was statistically significant ( P <0.001); the area under ROC curve for Model A obtained in the validation set was 0.902 (95% CI: 0.844–0.961), the area under ROC curve for Model B was 0.842 (95% CI: 0. 0.773–0.910), and the difference between the 2 models was statistically significant ( P =0.012). Conclusions Predictive Model A better predicts isolated calf muscle venous thrombosis and is able to help clinicians rapidly and early diagnose ICMVT, displaying higher utility for missed diagnosis prevention and disease therapy.

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Section: Discussionsupporting

confidence: 93%

Generation of a Predictive Clinical Model for Isolated Distal Deep Vein Thrombosis (ICMVT) Detection

Xu,

Zheng

et al. 2023

Med Sci Monit

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“…Multiple retrospective studies have also shown relatively low rates of propagation of distal DVT, regardless of treatment approach. Li et al, evaluated 310 consecutive patients after vascular surgery and found 33 with distal DVT 761 . These 33 patients were randomized into full dose or half dose anticoagulation with LMWH and no progression of DVT was reported in either group.…”

Section: -How Should Patients With Post-operative Distal Dvt Be Managed?mentioning

confidence: 99%

Recommendations from the ICM-VTE: General

2022

Journal of Bone and Joint Surgery

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“…Considering the risk of bleeding, only physical measures were taken to prevent DVT, with no drug prophylaxis. The patient's D-Dimer level remained high after SSRF, and several studies revealed that a high D-Dimer level was a high-risk predictor of DVT after thoracic surgery [21] . However, postoperative anticoagulant therapy was delayed until 48 h after surgery due to the excessive caution of surgeons.…”

Section: Discussionmentioning

confidence: 99%

Rare acute pulmonary thromboembolism after internal fixation for isolated multiple rib fractures: a case report

Xu,

Yang,

Pen

et al. 2023

Preprint

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Background Multiple rib fractures are common in emergency trauma patients with high mortality. Acute pulmonary thromboembolism (PTE) is rare and has not been reported in patients with isolated multiple rib fractures after surgical stabilization of rib fractures (SSRF). We report a case of a 64-year-old patient presenting with PTE after SSRF due to non-standardized anticoagulant therapy; it should attract enough attention from thoracic surgeons. Case presentation A 64-year-old male was admitted to our hospital with multiple rib fractures, pulmonary contusion, bilateral pleural effusion, and incomplete right lung expansion. The patients were treated on the sixth day of their hospitalization with thoracoscopic exploration combined with internal fixation of the right fracture of the sixth to eighth ribs. He started anticoagulant therapy 48 h after the operation to prevent deep vein thrombosis with low molecular weight heparin 2500 units once daily. He gradually recovered from the operation, and his symptoms improved. The patient was diagnosed with acute PTE based on pulmonary artery angiography of CT on the fourth day after surgery; since that time, he has been treated with a subcutaneous injection of 60 mg enoxaparin every 12 h. After two weeks of anticoagulant therapy, they were discharged from the hospital and continued to receive oral anticoagulant therapy. The patient was followed up for three months after discharge, and everything was normal. Conclusion Acute PTE after isolated multiple rib fractures is rare; although SSRF is a relatively safe and effective treatment for multiple rib fractures with dislocation, perioperative deep vein thrombosis, including PTE and deep vein thrombosis, should be given sufficient attention by clinicians. The standardized prevention of perioperative venous thromboembolism for multiple rib fractures requires further research due to the lack of high-quality clinical evidence support.

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Risk Factors and Anticoagulation Therapy in Patients With Isolated Distal Deep Vein Thrombosis in the Early Post-operative Period After Thoracic Surgery

Cited by 3 publications

References 62 publications

Generation of a Predictive Clinical Model for Isolated Distal Deep Vein Thrombosis (ICMVT) Detection

Generation of a Predictive Clinical Model for Isolated Distal Deep Vein Thrombosis (ICMVT) Detection

Recommendations from the ICM-VTE: General

Rare acute pulmonary thromboembolism after internal fixation for isolated multiple rib fractures: a case report

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