The significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for predicting venous thromboembolism: a prospective, single center study

Abstract

Background: The high incidence of venous thromboembolism (VTE) has been perceived in post thoracic surgery patients. However, the significance of perioperative coagulation and fibrinolysis related parameters after lung surgery for VTE predicting is not clear. To investigate that, we conducted a prospective single center study. Methods: A total of 111 patients undergoing lung surgery were enrolled in this study, included 52 primary were received further computer tomography pulmonary angiography (CTPA) for pulmonary embolism (PE).We used the area under receiver-operating-characteristic (ROC) curve to discriminate patients between those who developed VTE and those who did not. Single factor analysis was utilized to define risk factors associated with VTE. Results: The overall incidence of VTE was 16.2% (18/111). The incidence of VTE in primary lung cancer patients was 23.1% (12/52), much higher than that in benign lung diseases 10.2% (6/59), but did not reach statistical significance (P=0.066). Among 18 VTE patients, 83.3% was DVT, 16.7% was DVT + PE and 72.2% was muscular veins of the calf thrombosis. D-Dimer was much higher in VTE group than that in non-VTE group preoperatively and at postoperative days 1, 3 (0.64±0.24 vs. 0.33±0.06, P=0.007; 3.14±0.75 vs. 1.51±0.09, P=0.005, and 1.88±0.53 vs. 0.76±0.05, P=0.001, respectively). And the ROC curve areas of preoperative and postoperative days 1, 3 of D-Dimer were 0.70, 0.71 and 0.74, respectively. And FDP was much higher in VTE group than that in non-VTE group at postoperative day 3 (6.78±1.43 vs. 3.79±0.15, P=0.004). But AT, PT, PA, PR, INR, APTT, FBG and TT there were no significantly difference. Conclusions:The overall incidence of VTE after lung surgery was 16.2%. The patients with preoperative high D-Dimer should receive VTE prophylaxis.

Correlation between clinicopathological characteristics of lung adenocarcinoma and the risk of venous thromboembolism

“…VTE events mostly occur during hospitalization, including the perioperative period, and subsequent examinations or treatments, which support that hospitalization is an independent risk factor for VTE 22–24 . In addition, most VTE events in this study were found in the lower extremities which is in agreement with previously reported studies 25,26 . Therefore, we have the same recommendations as previous studies, 25 which is that lower‐extremity ultrasonography is probably required for screening post‐surgical DVT cases during hospitalization.…”

“… 22 , 23 , 24 In addition, most VTE events in this study were found in the lower extremities which is in agreement with previously reported studies. 25 , 26 Therefore, we have the same recommendations as previous studies, 25 which is that lower‐extremity ultrasonography is probably required for screening post‐surgical DVT cases during hospitalization.…”

Relationship between Hypercoagulable State and Circulating Tumor Cells in Peripheral Blood, Pathological Characteristics, and Prognosis of Lung Cancer Patients

“…In addition, FIB can reduce the sensitivity of tumor cells to chemotherapy and protect tumor cells while promoting their proliferation and metastasis [ 13 ]. D-D is the product of the degradation of cross-linked fibrin, whose level reflects the intensity of secondary fiber activity, and can be used to evaluate the progress of lung cancer or other malignant tumors [ 14 ].…”

Effectiveness of intraoperative administration of intermittent pneumatic compression in preventing deep vein thrombosis in lung cancer patients undergoing video-assisted thoracoscopic surgery lobectomy

“…Among patients with lung cancer, those undergoing major surgery have a particularly high risk of developing thromboembolic disease, since the major pathogenic elements of VTE-hypercoagulability, venous stasis, and vessel wall injury-are likely to be activated during operation (8). Studies have shown that the incidence of VTE after thoracic surgery varies from 5% to 16.2% (9)(10)(11)(12).…”