Venous Thromboembolism in Patients Undergoing Operations for Lung Cancer: A Systematic Review

Christensen, Thomas; Vad, Henrik; Pedersen, Søren; Hvas, Anne‐Mette; Wotton, Robin; Naidu, Babu; Larsen, Torben Bjerregaard

doi:10.1016/j.athoracsur.2013.10.074

Cited by 63 publications

(52 citation statements)

References 27 publications

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“…The VTE incidence after primary lung cancer surgery is 23.1%, which is much higher than that of benign lung diseases (10.2%). This finding is consistent with recent study (5). Lung cancer may be responsible for the higher incidence of thrombotic events associated with cancer, but do not reach statistical significance.…”

Section: Discussionsupporting

confidence: 83%

“…The surgery and tumor are the main causation of acquired hypercoagulability (1,2). The overall incidence of VTE after operation is approximately 0.8% to 1.6% (3,4), whereas the incidence of VTE after lung cancer surgery is higher than that, from 0.2% to 19% (5). A previous study show that the mortality rate of patients with VTE increase 6-fold, and half of the postoperative deaths are caused by VTE, about 2/3 VTE events occur before discharge (6).…”

Section: Introductionmentioning

confidence: 98%

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

Tian

Song

et al. 2018

J. Thorac. Dis.

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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.

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 98%

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

Tian

Song

et al. 2018

J. Thorac. Dis.

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“…Another recent systemic review by Christensen et al summarizing the results of 19 studies reported an overall risk of clinically detected VTE in patients undergoing operations for primary lung cancer to be as low as 2.0%, with the highest incidence present within 1 month of the operation (16). Despite analysing data from over 10,660 patients, all but one of the included studies were retrospective with marked heterogeneity, limiting the ability to pool the data.…”

Section: Discussionmentioning

confidence: 99%

Practice patterns in venous thromboembolism (VTE) prophylaxis in thoracic surgery: a comprehensive Canadian Delphi survey

Agzarian¹,

Linkins²,

Schneider³

et al. 2017

J. Thorac. Dis.

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Background: The incidence of venous thromboembolic events (VTE) after resection of thoracic malignancies can reach 15%, but prophylaxis guidelines are yet to be established. We aimed to survey Canadian practitioners regarding perioperative risk factors for VTE, impact of those factors on extended prophylaxis selection, type of preferred prophylaxis, and timing of initiation and duration of thromboprophylaxis. Methods: A modified Delphi survey was undertaken over three rounds with thoracic surgeons, thoracic anesthesiologists and thrombosis experts across Canada. Participants were asked to rate each parameter on a ten-point scale. Agreement was determined a priori as an item reaching a coefficient of variation of ≤30% (0.3), with the item then discontinued from later rounds. Results: In total, 72, 57 and 50 respondents participated in three consecutive rounds, respectively.Consensus was reached on previous VTE, age, cancer diagnosis, thrombophilia, poor mobilization, extended resections, and pre-operative chemotherapy as risk factors. Consensus on risk factors impacting extended prophylaxis decisions was achieved on cancer diagnosis, obesity, previous VTE and poor mobilization.With respect to perioperative prophylaxis, once daily low-molecular-weight heparin (LMWH) was the only parameter that demonstrated agreement as a common practice pattern. No agreement was achieved regarding the role of mechanical prophylaxis, unfractionated heparin (UFH) or timing of initiation of perioperative treatment. VTE prophylaxis until discharge reached agreement but there was substantial variability regarding the role of extended prophylaxis. Conclusions: There is agreement between Canadian clinicians treating patients with thoracic malignancies regarding most risk factors for VTE, but there is no agreement on timing of initiation of prophylaxis, the agents used or factors mandating usage of extended prophylaxis.

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“…Day et al recently reported a VTE rate of 1.2% for lower extremity arthroplasties, and only 0.53% for shoulder arthroplasties [60]. In a study of patients undergoing operations for lung cancer, on the other hand, Christensen et al reported a mean risk of 2.0% [61]. Stein et al report the rate of VTE in brain cancer patients, on the other hand, to be 3.5 diagnoses per 100 hospitalizations [15].…”

Section: Vte In Brain Tumor Patientsmentioning

confidence: 99%

Venous Thromboembolism in Brain Tumor Patients: A Review of Literature

Coté¹,

Smith

2015

J Hematol Thrombo Dis

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Venous thromboembolism (VTE) is a relatively common and well-described condition, affecting approximately 1-2% of the general population. VTE can lead to significant morbidity and death via pulmonary embolism (PE). During the post-operative period, VTE occurs at higher rates due to natural thrombotic responses to injury and limited post-operative mobility. In general, rates of post-operative VTE are higher in patients undergoing operations for cranial and spinal lesions than for lesions of other types, a phenomenon that is not fully explained. Several studies have demonstrated that other risk factors for VTE include age, sex, ethnicity, hospital stay length, and coagulation state. Aggressive chemical and mechanical measures for VTE prophylaxis are indicated in the postoperative period to prevent the formation of VTE. Here we review the literature on VTE in brain tumor patients, with a focus on their etiology, diagnosis, treatment, and prophylaxis.

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Venous Thromboembolism in Patients Undergoing Operations for Lung Cancer: A Systematic Review

Cited by 63 publications

References 27 publications

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

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

Practice patterns in venous thromboembolism (VTE) prophylaxis in thoracic surgery: a comprehensive Canadian Delphi survey

Venous Thromboembolism in Brain Tumor Patients: A Review of Literature

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