LOU Neng,CAI Weilong,YE Guochao. Risk factors of postoperative venous thromboembolism in patients with gastrointestinal malignancies[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(11): 905-910，916.
Abstract：Objective: To investigate the risk factors of venous thromboembolism (VTE) in patients with gastrointestinal malignancies after surgery. Methods: Clinical data of 518 patients who underwent radical surgery for gastric or colorectal cancer in Huzhou Central Hospital between January 2017 and June 2020 were retrospectively collected to understand the characteristics of postoperative VTE in gastrointestinal malignancies.Patients were divided into VTE group (72 patients) and non-VTE group (446 patients) according to whether or not VTE occurred after surgery. Then clinical data were analyzed for postoperative VTE-related factors by univariate analysis, and the independent risk factors for postoperative VTE were explored by multivariate Logistic regression analysis. Results: Of the 518 patients with gastrointestinal malignancies, 72 cases developed postoperative VTE, with an incidence of 13.90%, including 53 cases with deep vein thrombosis (DVT) and 19 cases with pulmonary embolism (PE). Univariate analysis revealed that patients in the VTE group had older age,higher postoperative D-dimer levels, higher incidence of diabetes mellitus and preoperative chemotherapy than patients in the non-VTE group, and their tumor stage was later than that in the non-VTE group. VTE group had lower rate of perioperative mechanical and pharmacologic prophylaxis than non-VTE group, with significant differences (P<0.05). Multivariate analysis showed that aging (≥65 year, OR=1.781, 95%CI=1.009-3.145, P=0.046), late tumor stage (III/IV, OR=1.960, 95%CI=1.135-3.387, P=0.016) and elevated postoperative D-dimer(≥5 mg/mL, OR=2.936, 95%CI=1.542-5.591, P=0.001) were independent risk factors for postoperative VTE in patients with gastrointestinal malignancies. Perioperative mechanical prophylaxis (OR=0.528, 95%CI=0.309-0.792,P=0.018) and pharmacologic prophylaxis (OR=0.652, 95%CI=0.326-0.798, P=0.031) were protective factors for postoperative VTE. Conclusions: Risk factors for postoperative VTE in patients with gastrointestinal malignancies include aging (≥65 year), late tumor stage (III/IV) and postoperative elevated D-dimer (≥5mg/mL).
