Risk Factors for Postoperative Venous Thromboembolic Complications after Microsurgical Breast Reconstruction

Sultan, Steven M.; Jackson, Donald E.; Erhard, Heather A.; Greenspun, David T.; Benacquista, Teresa; Garfein, Evan S.; Weichman, Katie E.

doi:10.1055/s-0037-1608629

Cited by 13 publications

(16 citation statements)

References 38 publications

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“…Three studies examined whether longer RBC storage times were associated with higher venous thrombosis rates. 27,44,45 None of these analyses showed statistically significant differences.…”

Section: Resultsmentioning

confidence: 87%

“…33,39,55 Some studies reported frequencies of drug anticoagulation in their patients. None of the seven studies with overall high-anticoagulation rates of 98 to 100% 26,27,35,39,43,47,49 had an MV-positive transfusion-thrombosis correlation, compared with 3 25,40,41 of 10 (30%) with anticoagulation rates of 0 to 75% or "rare" or "most." 25,29,31,36,38,40,41,[50][51][52] However, three of the high-anticoagulation studies still had UV-positive correlation with transfusion and/or correlation with transfusion volume.…”

Section: Resultsmentioning

confidence: 93%

“…55 The fifth UV-positive/no MV study was in endometrial cancer. 51 One of the two breast-cancer reconstruction 27 We stratified all of the 31 categorical studies according to several parameters to examine possible influences on the likelihood of the MV-positive transfusion-thrombosis associations. All six MV-positive studies had overall thrombosis rates (►Table 1) in the intermediate range between 1.4 and 6.0% (6 of 15 studies in this range), compared with none of 16 studies with lower or higher rates (p < 0.01, Fisher's exact test).…”

Section: Resultsmentioning

confidence: 99%

“…40,46,55 All of the MV-positive studies were conducted retrospectively (►Table 1). Among the five studies which sought thrombosis prospectively-four by ultrasound 31,36,39,49 and one by clinical signs and symptoms 26 studies found higher RBC transfusion volumes in thrombosis cases by UV analysis 27,30,35,48 ; one of these studies proceeded to MV analysis which was negative. 35 The other three studies stratified cases according to increasing RBC units and all three found MV-confirmed correlation.…”

Section: Resultsmentioning

confidence: 99%

“…25,29,31,36,38,40,41,[50][51][52] However, three of the high-anticoagulation studies still had UV-positive correlation with transfusion and/or correlation with transfusion volume. 27,39,43 More data are needed to draw a firm conclusion about the effect of anticoagulation rates. Three studies examined whether longer RBC storage times were associated with higher venous thrombosis rates.…”

Section: Resultsmentioning

confidence: 99%

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Thrombosis Risk in Cancer Patients Receiving Red Blood Cell Transfusions

Ramsey

Lindholm

2019

Semin Thromb Hemost

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Patients with cancer have increased risk of thrombosis and often need red blood cell (RBC) transfusions. However, RBC transfusions may also promote thrombosis because of raised hematocrit and viscosity, storage-related RBC damage, and exposure to thrombogenic mediators from obsolescent RBCs. The authors conducted a literature survey for studies examining whether RBC transfusions were associated with increased risk of venous thromboembolism (VTE) in cancer patients. In perioperative cancer surgery patients with categorical comparisons of any versus no RBC transfusion, increased risk of VTE with RBC transfusion was found in 11 of 31 studies, 5 by univariate correlation only and 6 in multivariate analysis. All six multivariate-positive studies had intermediate overall rates of thrombosis (1.4–6.0%), and three were in urological surgery series. In the larger studies of > 2,000 patients (range: 2,219–44,656), the maximum odds ratio among the multivariate-positive studies was 1.3. Perioperative RBC transfusion volume was more strongly associated with VTE risk, with a positive association in six of seven studies. One large registry-based study of hospitalized cancer patients, not restricted to the perioperative setting, found an adjusted odds ratio of 1.60 (95% confidence interval: 1.53–1.67) for VTE risk in patients receiving RBCs compared with nontransfused patients.

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“…Three studies examined whether longer RBC storage times were associated with higher venous thrombosis rates. 27,44,45 None of these analyses showed statistically significant differences.…”

Section: Resultsmentioning

confidence: 87%