Venous Thromboembolism Incidence and Prophylaxis Use After Gastrectomy Among Korean Patients With Gastric Adenocarcinoma

Jung, Yoon Ju; Seo, Ho Seok; Park, Cho Hyun; Jeon, Hae Myung; Kim, Ji-Il; Yim, Hyeon Woo; Song, Kyo Young

doi:10.1001/jamasurg.2018.2081

Cited by 50 publications

(44 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of DVT ranges from 2.1% to 5% in this population. [46,47] In the present study, the incidence of DVT was 0.31% in the pre-implementation group, and 0.08% in the post-implementation group ( P = .02). This incidence was lower than the rates reported in the previous studies.…”

Section: Discussionsupporting

confidence: 41%

Impacts of the surgical safety checklist on postoperative clinical outcomes in gastrointestinal tumor patients

Wang

Zheng

Chen³

et al. 2019

Medicine

View full text Add to dashboard Cite

A 19-item surgical safety checklist (SSC) was published by the World Health Organization in 2008 and was proved to reduce postoperative complications. To date, however, the impacts of SSC implementation in China have not been evaluated clearly. The study was performed to evaluate the impacts of the SSC on postoperative clinical outcomes in gastrointestinal tumor patients. Between April 2007 and March 2013, 7209 patients with gastrointestinal tumor who underwent elective surgery at the Affiliated Hospital of Qingdao University were studied. Data on the clinical records and outcomes of 3238 consecutive surgeries prior to SSC implementation were retrospectively collected; data on another 3971 consecutive surgeries performed after SSC implementation were prospectively collected. The clinical outcomes (including mortality, morbidity, readmission, reoperation, unplanned intervention and postoperative hospital stay) within postoperative 30 days were compared between the two groups. Univariate and multivariate logistic regression analysis were performed to identify independent factors for postoperative complications. The rates of morbidity and in-hospital mortality before and after SSC implementation were 16.43% vs 14.33% ( P = .018), 0.46% vs 0.18% ( P = .028), respectively. Median of postoperative hospital stay in post-implementation group was shorter than that in pre-implementation group (8 vs 9 days, P < .001). Multivariable analysis demonstrated that the SSC was an independent factor influencing postoperative complications (odds ratio = 0.860; 95% CI, 0.750–0.988). Implementation of the SSC could improve the clinical outcomes in gastrointestinal tumor patients undergoing elective surgery in China.

show abstract

Section: Discussionsupporting

confidence: 41%

Impacts of the surgical safety checklist on postoperative clinical outcomes in gastrointestinal tumor patients

Wang

Zheng

Chen³

et al. 2019

Medicine

View full text Add to dashboard Cite

show abstract

“…36,60,62,68,[118][119][120][121][122][123][124][125][126][127][128][129][130][131][132] Our systematic search of RCTs identified 5 additional studies that fulfilled the inclusion criteria. 70,72,[133][134][135][136] Fourteen studies reported the effect of combined mechanical and pharmacological prophylaxis compared with mechanical prophylaxis alone on the risk of mortality. 36,60,62,68,120,121,124,125,127,128,130,133,134,136 Sixteen studies reported the effect on the development of symptomatic PEs, 60,62,70,[120][121][122][123][124][125...…”

Section: Recommendationmentioning

confidence: 99%

“…70,72,[133][134][135][136] Fourteen studies reported the effect of combined mechanical and pharmacological prophylaxis compared with mechanical prophylaxis alone on the risk of mortality. 36,60,62,68,120,121,124,125,127,128,130,133,134,136 Sixteen studies reported the effect on the development of symptomatic PEs, 60,62,70,[120][121][122][123][124][125][126][127][128][129][130][131]134 and 11 studies reported on the effect on any PEs 36,118,120,121,126,128,130,131,133,135,136 Six studies reported data on symptomatic DVTs, ...…”

Section: Recommendationmentioning

confidence: 99%

“…62,70,[120][121][122]124,125,127,128,130 Five studies reported data on symptomatic distal DVTs, 70,120,127,128,131 and 14 studies reported on any distal DVT. 118,[120][121][122]124,125,127,128,130 Fifteen studies reported the effect of combined mechanical and pharmacological prophylaxis on the risk of major bleeding, 60,62,68,118,119,121,[123][124][125]127,128,130,[134][135][136] and 4 studies reported the effect on the risk of reoperation. 118,125,134,135 The EtD framework is available online at https://guidelines.gradepro.org/ profile/75138F44-7AFE-A008-A8BD-10DD1DFD5377.…”

Section: Recommendationmentioning

confidence: 99%

See 1 more Smart Citation

American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients

et al. 2019

View full text Add to dashboard Cite

Background:Venous thromboembolism (VTE) is a common source of perioperative morbidity and mortality.Objective:These evidence-based guidelines from the American Society of Hematology (ASH) intend to support decision making about preventing VTE in patients undergoing surgery.Methods:ASH formed a multidisciplinary guideline panel balanced to minimize bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline-development process, including performing systematic reviews. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations, which were subject to public comment.Results:The panel agreed on 30 recommendations, including for major surgery in general (n = 8), orthopedic surgery (n = 7), major general surgery (n = 3), major neurosurgical procedures (n = 2), urological surgery (n = 4), cardiac surgery and major vascular surgery (n = 2), major trauma (n = 2), and major gynecological surgery (n = 2).Conclusions:For patients undergoing major surgery in general, the panel made conditional recommendations for mechanical prophylaxis over no prophylaxis, for pneumatic compression prophylaxis over graduated compression stockings, and against inferior vena cava filters. In patients undergoing total hip or total knee arthroplasty, conditional recommendations included using either aspirin or anticoagulants, as well as for a direct oral anticoagulant over low-molecular-weight heparin (LMWH). For major general surgery, the panel suggested pharmacological prophylaxis over no prophylaxis, using LMWH or unfractionated heparin. For major neurosurgery, transurethral resection of the prostate, or radical prostatectomy, the panel suggested against pharmacological prophylaxis. For major trauma surgery or major gynecological surgery, the panel suggested pharmacological prophylaxis over no prophylaxis.

show abstract

“…This begets improved targeted primary thromboprophylaxis; in the randomized, controlled, PROTECTOR trial, the use of prophylactic LMWH postoperatively in 682 patients with gastric cancer undergoing gastrectomy reduced the rates of postoperative VTE from 3.6% to 0.6%. 40 Indeed, the current guidelines are in favor of extended thromboprophylaxis for cancer-associated abdominal surgery. 7,41 However, only 19.4% of the patients were postsurgical thrombosis in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Outcomes after venous thromboembolism in patients with gastric cancer: Analysis of the RIETE Registry

et al. 2020

View full text Add to dashboard Cite

Gastric cancer is the fifth most common malignancy worldwide. Venous thromboembolism is an independent predictor of death among patients with gastric cancer. We aimed to describe the factors associated with mortality, thrombosis recurrence, and bleeding complications in patients with gastric cancer who develop venous thromboembolism. We included 612 patients with gastric cancer and venous thromboembolism in the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) registry from 2001 to 2018. We used Cox proportional hazard ratios and a Fine–Gray model to define factors associated with outcomes. The overall mortality at 6 months was 44.4%. Factors associated with increased 6-month mortality included immobility (HR 1.8, 95% CI 1.3–2.4; p < 0.001), anemia (HR 1.4, 95% CI 1.1–1.8; p < 0.02), and leukocytosis (HR 1.8, 95% CI 1.4–2.3; p < 0.001). Recurrent thrombosis occurred in 6.5% of patients and major bleeding complications in 8.5% of the cohort. Male sex was the main factor associated with thrombosis recurrence (HR 2.1, 95% CI 1.1–4.0; p < 0.02) and hemoglobin below 10 g/dL (HR 1.6, 95% CI 1.05–2.50; p = 0.03) the main factor associated with bleeding. In conclusion, patients with gastric cancer who develop venous thrombosis have a very high likelihood of death. Low hemoglobin in this population is associated with poor outcomes.

show abstract

Venous Thromboembolism Incidence and Prophylaxis Use After Gastrectomy Among Korean Patients With Gastric Adenocarcinoma

Abstract: ClinicalTrials.gov Identifier: NCT01448746.

Cited by 50 publications

References 48 publications

Impacts of the surgical safety checklist on postoperative clinical outcomes in gastrointestinal tumor patients

Impacts of the surgical safety checklist on postoperative clinical outcomes in gastrointestinal tumor patients

American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients

Outcomes after venous thromboembolism in patients with gastric cancer: Analysis of the RIETE Registry

Contact Info

Product

Resources

About