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Background The prevalence of deep venous thrombosis (DVT) in patients with gastric cancer before surgery is unknown. This study aimed to clarify the risk factors for DVT of the lower extremities in patients with gastric cancer before surgery and to evaluate the usefulness of ultrasonographic screening for prevention of postoperative pulmonary thromboembolism (PTE). Methods Patients who had undergone lower-extremity venous ultrasonography before surgery for gastric cancer were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify the predictors of DVT before surgery. Perioperative management of patients with DVTs and the incidence of postoperative PTE were investigated. Results Of the total 1140 patients, 86 had DVT preoperatively. On univariate analysis, the incidence of DVT was significantly higher with: female sex; age C80 years; PS C 1 (vs. PS = 0); stage IV (vs. stages I-III); history of preoperative chemotherapy; and the presence of a central venous catheter (CVC). Multivariate logistic regression analysis demonstrated that sex, age C80 years, PS C 1, history of preoperative chemotherapy, and the presence of CVC were significantly correlated with DVT before surgery. Postoperative PTE occurred in 2 patients with proximal DVT. No patients in whom DVT was not detected developed PTE. Conclusions Female sex, older age, worse PS, the presence of CVC, and a history of preoperative chemotherapy were the independent risk factors for DVT. Routine lower-extremity venous ultrasonographic screening is useful for prevention of PTE because it can identify patients at high or low risk for PTE.

In this study, we developed a simulation model of detailed in-hospital disaster response to a mass casualty incident based on the analysis of related documents and actual in-hospital disaster response training, aiming to assess the hospital’s response capacity under various disaster situations. This simulation model includes detailed models of patients, floor configurations, resources, and response tasks, which consider resource requirements for the treatment of different patients with various injuries and physical conditions. The model covers patients’ arrivals to hospitalization or discharge. We conducted simulations of the target hospital to test two resource allocation strategies under two patient scenarios. By comparing the results under different resource allocation strategies, we found that the X-ray photography examination capacity could become a fundamental bottleneck in responding to mass casualty incidents. Also, we found that the appropriate resource allocations and quick replenishment could alleviate the negative effect of resource shortages and maintain a higher performance. Furthermore, the results show that the length of stay can be heavily affected by the patients’ configuration. As a result, by monitoring and anticipating the situation, a resilient and responsive resource allocation strategy must be prepared to handle such uncertain disaster situations.

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