Universal venous thromboembolism policy is effective but may not adequately protect hospitalized cancer patients with larger BMI

Xu, Anna; Sibai, Hassan; Atenafu, Eshetu G.; Japs, Kelsey; Seki, Jack T

doi:10.1007/s11239-019-01975-x

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…In our predictive model, in addition to NETs, BMI, Neutrophils, and D-dimer were also predictors of postoperative DVT. Patients with higher BMI had an increased risk of DVT after spine surgery, and this study noted that the probability of venous thrombosis increased by 9.4% for every 1 kg/m 2 increase in BMI ( Xu et al, 2020 ). Patients with high BMI may have relatively more adipose tissue, leading to increased release of inflammatory cytokines and enhanced synthesis of tissue factor, which activates exogenous coagulation pathways and thus promotes thrombus formation ( Hunt, 2017 ).…”

Section: Discussionmentioning

confidence: 83%

A prospective marker for the prediction of postoperative deep venous thrombosis: Neutrophil extracellular traps

Yin

Jiang²,

Zhou³

et al. 2022

Front. Cell Dev. Biol.

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Deep venous thrombosis (DVT) is a common medical complication in patients with lumbar fractures. The current study aimed to investigate the predictive value of neutrophil extracellular traps (NETs) in postoperative DVT formation in patients with lumbar fractures and to develop a nomogram relating clinical admission information for prediction. Patients who underwent open reduction and pedicle screw internal fixation in the treatment of single-segment lumbar fracture in the Department of Spine Surgery, the First Affiliated Hospital of Nanjing Medical University, from December 2020 to June 2022 were enrolled in this study. Baseline data and laboratory results were collected from enrollees, and the primary study endpoint event was the occurrence of DVT in patients after surgery. Multivariable logistic regression analysis was used to identify risk factors associated with higher odds of DVT after surgery. A nomogram was constructed using the results of the multivariable model. The calibration plot and receiver operating characteristics (ROC) curve were used to show the satisfactory predictive capacity of the model. Of these 393 patients who did not have DVT preoperatively, 79 patients developed it postoperatively, and 314 did not, respectively. Multivariate analysis showed that higher body mass index (BMI) (BMI between 24 and 28: RR = 1.661, 95% CI = 0.891–3.094; BMI ≤28: RR = 5.625, 95% CI = 2.590–12.217; reference: BMI <24), neutrophils (RR = 1.157, 95% CI 1.042–1.285), D-dimer (RR = 1.098, 95% CI 1.000–1.206), and citrullinated histone H3 (CitH3) (RR = 1.043, 95% CI 1.026–1.060) were independent risk factors for postoperative DVT. Using the multivariable analysis, we then constructed a nomogram to predict DVT, which was found to have an area under the curve of 0.757 (95% CI = 0.693–0.820). Calibration plots also showed the satisfied discrimination and calibration of the nomogram. In conclusion, patients with lumbar fractures with postoperative DVT had higher levels of NETs in the circulation preoperatively compared to those without postoperative DVT. Furthermore, based on BMI, D-dimer, neutrophils, and CitH3, we developed a predictive model to predict postoperative DVT incidence in these patients.

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Section: Discussionmentioning

confidence: 83%

A prospective marker for the prediction of postoperative deep venous thrombosis: Neutrophil extracellular traps

Yin

Jiang²,

Zhou³

et al. 2022

Front. Cell Dev. Biol.

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“…In a retrospective study with 7602 cancer patients receiving thromboprophylaxis, body mass index (BMI) was found to be a significant predictor of VTE (OR = 1.094, 95% CI 1.021-1.172, p = 0.011). Cancer patients with high BMI may pose a risk of breaking through standard thromboprophylaxis dosage [35].…”

Section: Obesitymentioning

confidence: 99%

Current status of treatment of cancer-associated venous thromboembolism

Xiong

2021

Thrombosis J

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Patients with cancer are prone to develop venous thromboembolism (VTE) that is the second leading cause of mortality among them. Cancer patients with VTE may encounter higher rates of VTE recurrence and bleeding complications than patients without cancer. Treatment of established VTE is often complex in patients with cancer. Treatment of cancer-associated VTE basically comprises initial treatment, long-term treatment, treatment within 6 months, treatment beyond 6 months, treatment of recurrent VTE, and treatment in special situations. Decision of antithrombotic therapy, selection of anticoagulants, duration of anticoagulation, decision of adjuvant therapy, and adjustment of regimen in special situations are the major problems in the treatment of cancer-associated VTE. Therapeutic anticoagulation is the key of the key in the treatment of cancer-associated VTE. In addition to the efficacy and safety of low-molecular-weight heparin (LMWH) that has been fully demonstrated, direct oral anticoagulants (DOACs) are increasingly showing its advantages along with the accompanying concern in the treatment of cancer-associated VTE. The latest ASCO, ITAC and NCCN guidelines agree with each other on most aspects with respect to the treatment of cancer-associated VTE, whereas differ on a few issues. Encompassing recent randomized controlled trials, clinical trials, and meta-analyses, as well as the comparison of the latest authoritative guidelines including the NCCN, ASCO, and ITAC guidelines in this field, the objective of this review is to present current overview and recommendations for the treatment of cancer-associated VTE.

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Universal venous thromboembolism policy is effective but may not adequately protect hospitalized cancer patients with larger BMI

Cited by 2 publications

References 25 publications

A prospective marker for the prediction of postoperative deep venous thrombosis: Neutrophil extracellular traps

A prospective marker for the prediction of postoperative deep venous thrombosis: Neutrophil extracellular traps

Current status of treatment of cancer-associated venous thromboembolism

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