Prevalence of venous thromboembolism after lung surgery in China: a single-centre, prospective cohort study involving patients undergoing lung resections without perioperative venous thromboembolism prophylaxis†

Song, Chun; Shargall, Yaron; Li, Hui; Tian, Bo; Chen, Shuo; Miao, Jinbai; Fu, Yili; You, Bo; Hu, Bin

doi:10.1093/ejcts/ezy323

Cited by 37 publications

(39 citation statements)

References 24 publications

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“…Most patients in the present series underwent surgery. In contemporary studies describing the incidence of venous thrombo-embolism following general thoracic surgery for other indication, mostly lung cancer, significantly lower (0.005-1.7%) rates have been reported, though higher percentages have also been observed in older series and when no perioperative antithrombotic prophylaxis was administered [6,7,20]. Despite routine in-hospital thrombo-prophylaxis, the early occurrence of thrombo-embolic events was relatively high in this study.…”

Section: Discussioncontrasting

confidence: 53%

High Occurrence of Thrombo-Embolic Complications During Long-Term Follow-up After Pleural Infections—A Single-Center Experience with 536 Consecutive Patients Over 17 Years

Ala-Seppälä

Ukkonen

Lehtomäki

et al. 2020

Lung

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Purpose Pleural infections are associated with significant inflammation, long hospitalizations, frequent comorbidities, and are often treated operatively-all of which are consequential risk factors for thrombo-embolic complications. However, their occurrence following the treatment of pleural infection is still unknown. The aim of the study was to ascertain the early and long-term occurrence of thrombo-embolic events in patients treated for pleural infections. Methods The study included all patients that were treated for pleural infections in Tampere University Hospital between January 2000 and December 2016. Data regarding later treatment episodes due to pulmonary embolisms and/or deep vein thromboses as well as survival data were requested from national registries. The rates were also compared to a demographically matched reference population adjusted for age, sex, and the location of residence. Results The final study population comprised 536 patients and 5318 controls (median age 60, 78% men). The most common etiology for pleural infection was pneumonia (73%) and 85% underwent surgical treatment for pleural infection. The occurrence of thrombo-embolic complications in patients and controls was 3.8% vs 0.1% at three months, 5.0% vs 0.4% at one year, 8.8% vs 1.0% at three years, and 12.4% vs 1.8% at five years, respectively, p < 0.001 each. Female sex, advanced age, chronic lung disease, immunosuppression, video-assisted surgery, and non-pneumonic etiology were associated with a higher incidence of thrombo-embolism. Conclusions The occurrence of thrombo-embolic events-particularly pulmonary embolism but also deep vein thrombosis-was significant in patients treated for pleural infections, both initially and during long-term follow-up.

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Section: Discussioncontrasting

confidence: 53%

High Occurrence of Thrombo-Embolic Complications During Long-Term Follow-up After Pleural Infections—A Single-Center Experience with 536 Consecutive Patients Over 17 Years

Ala-Seppälä

Ukkonen

Lehtomäki

et al. 2020

Lung

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“…The first study on risk scoring for VTE occurrence, by Song et al (64), evaluated the VTE rates in 262 Chinese patients, of which 147 had lung cancer who underwent surgery without peri-operative thromboprophylaxis. The VTE rate in lung cancer (15%) was twice that of benign cases (7%) (64).…”

Section: Risk Scores For Prediction Of Vte Occurrence and Recurrence In Cancer Patientsmentioning

confidence: 99%

Epidemiology of Cancer-Associated Thrombosis in Asia: A Systematic Review

Lee

Nagarajan

Tan

et al. 2021

Front. Cardiovasc. Med.

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The epidemiology of cancer associated thrombosis (CAT) in Asia is less well-studied and differs from that in the western countries. Here, we systematically examine population based and hospital-based studies reported between 1995 and 2020 to understand the epidemiology of CAT in Asia. From population-based studies, the estimated incidence of VTE in cancer patients was 1.85–9.88 per 1,000 person-years. The incidence of CAT in Asia is significantly higher than non-cancer associated VTE in the general population and cancer is perhaps the most important risk factor for VTE. Hospital-based studies were heterogeneous in study designs and reveal a wide range of prevalence of VTE among cancer patients at 0.5–44.6% while the cancer prevalence rates among VTE patients ranged from 6.1 to 65.5%. The cancer sites most associated with VTE and risk factors were similar between Asian and Western studies. CAT has a major impact on the survival of patients with cancer in Asia, but thromboprophylaxis is not commonly practiced and validated risk assessment tools are lacking. This study highlights the urgent need for large multinational epidemiological studies in Asia to establish the true burden of CAT and to guide appropriate prevention strategies.

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“…In the studies of non-induction therapy, a dissertation reported the postoperative rate of VTE changes depending on the extent of operation (lobectomy or bilobectomy vs. pneumonectomy) and surgical approach (video-assisted thoracic surgery vs. thoracotomy) [ 9 ]. However, another study reported that the incidence of VTE did not differ according to the surgical approach (minimally invasive surgery vs. open surgery) or the extent of operation (lobectomy, wedge resection and pneumonectomy) [ 10 ]. There was no fixed consensus on the relationship between the incidence of postoperative VTE and the surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism in non-small cell lung cancer patients who underwent surgery after induction therapy

Kaminuma

Tanahashi

Suzuki

et al. 2020

Gen Thorac Cardiovasc Surg

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Objectives Lung cancer patients have been reported to have a high incidence of venous thromboembolism (VTE) and a high recurrence rate of VTE. However, there are no detailed reports of VTE in lung cancer patients who underwent surgery after induction therapy. We examined the incidence and clinical features of VTE in these patients. Methods We retrospectively evaluated 89 patients with non-small cell lung cancer who underwent surgery after induction therapy at our department between April 2009 and March 2018. The incidence of VTE, clinical features, and long-term prognosis were retrospectively examined. Results Among the 89 patients, 4 (4.5%) developed VTE, and there was no significant difference in the background characteristics between patients with and without VTE. All four patients developed VTE during preoperative treatment. In the patients with VTE, anticoagulant therapy with oral anticoagulants was administered after heparinization, and the median duration of anticoagulant therapy was 18.7 months. There were no cases of symptomatic VTE recurrence after surgery, regardless of lung cancer recurrence. Although the overall survival (OS) showed no significant difference between patients with and without VTE, the disease-free survival was significantly shorter in patients with VTE than in those without it (median 6.3 vs. 71.6 months, p < 0.01). Conclusions In induction cases, the incidence of VTE was 4.5%, and it can at least be stated that no symptomatic VTE developed or recurred after surgery. Patients with VTE in induction therapy had short progression-free survival and required careful follow-up after surgery.

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Prevalence of venous thromboembolism after lung surgery in China: a single-centre, prospective cohort study involving patients undergoing lung resections without perioperative venous thromboembolism prophylaxis†

Cited by 37 publications

References 24 publications

High Occurrence of Thrombo-Embolic Complications During Long-Term Follow-up After Pleural Infections—A Single-Center Experience with 536 Consecutive Patients Over 17 Years

High Occurrence of Thrombo-Embolic Complications During Long-Term Follow-up After Pleural Infections—A Single-Center Experience with 536 Consecutive Patients Over 17 Years

Epidemiology of Cancer-Associated Thrombosis in Asia: A Systematic Review

Venous thromboembolism in non-small cell lung cancer patients who underwent surgery after induction therapy

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