Skip to main content
Log in

The prevalence and risk factors associated with preoperative deep venous thrombosis in lung cancer surgery

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

Few studies have so far focused on the preoperative presence of venous thromboembolism (VTE) in lung cancer patients undergoing surgery. In this study, we investigated the prevalence and risk factors for preoperative deep venous thrombosis (DVT) in patients scheduled to undergo lung cancer surgery.

Methods

Between June 2013 and December 2018, 948 consecutive patients underwent lung cancer surgery in Kindai University Hospital. Four patients did not undergo screening for DVT; thus, 944 patients were enrolled in this study. Preoperatively, venous ultrasonography of the lower extremities was performed in patients deemed at risk for DVT, and the prevalence and risk factors for preoperative DVT were examined.

Results

Ninety-one patients (9.6%) were diagnosed with preoperative DVT, and postoperative symptomatic pulmonary thromboembolism occurred in one patient (0.11%). A multivariable logistic regression analysis demonstrated that female sex, age ≥ 72 years, history of VTE, a Wells score ≥ 2 points, chronic obstructive pulmonary disease (COPD), and lower hemoglobin levels were significantly associated with preoperative DVT.

Conclusion

Female sex, age ≥ 72 years, history of VTE, Wells score ≥ 2 points, COPD, and lower hemoglobin levels were identified to be independent risk factors for preoperative DVT. Monitoring for these risk factors and management considering them should help improve the outcomes after lung cancer surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gould MK, Garcia DA, Wren SM, Karanicolas PJ, Arcelus JI, Heit JA, et al. Prevention of VTE in nonorthopedic surgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e227S-e277S.

    Article  CAS  Google Scholar 

  2. JCS Joint Working Group. Guidelines for the diagnosis, treatment and prevention of pulmonary thromboembolism and deep vein thrombosis (JCS 2009). Circ J. 2011;75:1258–81.

    Article  Google Scholar 

  3. Khorana AA. The NCCN clinical practice guidelines on venous thromboembolic disease: strategies for improving VTE prophylaxis in hospitalized cancer patients. Oncologist. 2007;12:1361–70.

    Article  CAS  Google Scholar 

  4. Liem TK, Huynh TM, Moseley SE, Minjarez RC, Landry GJ, Mitchell EL, et al. Symptomatic perioperative venous thromboembolism is a frequent complication in patients with a history of deep vein thrombosis. J Vasc Surg. 2010;52:651–7.

    Article  Google Scholar 

  5. Song K, Yao Y, Rong Z, Shen Y, Zheng M, Jiang Q. The preoperative incidence of deep vein thrombosis (DVT) and its correlation with postoperative DVT in patients undergoing elective surgery for femoral neck fractures. Arch Orthop Trauma Surg. 2016;136:1459–64.

    Article  Google Scholar 

  6. Bates SM, Jaeschke R, Stevens SM, Goodacre S, Wells PS, Stevenson MD, et al. Diagnosis of DVT: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e351S-418S.

    Article  CAS  Google Scholar 

  7. Wells PS, Anderson DR, Bormanis J, Guy F, Mitchell M, Gray L, et al. Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet. 1997;350:1795–8.

    Article  CAS  Google Scholar 

  8. Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111:4902–7.

    Article  CAS  Google Scholar 

  9. Wells PS, Anderson DR, Rodger M, Forgie M, Kearon C, Dreyer C, et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med. 2003;349:1227–35.

    Article  CAS  Google Scholar 

  10. Ruiz-Gimenez N, Friera A, Artieda P, Caballero P, Sanchez Molini P, Morales M, et al. Rapid D-dimer test combined a clinical model for deep vein thrombosis. Validation with ultrasonography and clinical follow-up in 383 patients. Thromb Haemost. 2004;91:1237–46.

    Article  CAS  Google Scholar 

  11. Ho KM, Tan JA. Stratified meta-analysis of intermittent pneumatic compression of the lower limbs to prevent venous thromboembolism in hospitalized patients. Circulation. 2013;128:1003–20.

    Article  CAS  Google Scholar 

  12. Sakon M, Kakkar AK, Ikeda M, Sekimoto M, Nakamori S, Yano M, et al. Current status of pulmonary embolism in general surgery in Japan. Surg Today. 2004;34:805–10.

    Article  Google Scholar 

  13. Kearon C, Akl EA, Comerota AJ, Prandoni P, Bounameaux H, Goldhaber SZ, et al. Antithrombotic therapy for VTE disease: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e419S-e496S.

    Article  CAS  Google Scholar 

  14. Hasegawa M, Wada H, Yamaguchi T, Wakabayashi H, Fujimoto N, Matsumoto T, et al. The evaluation of D-dimer levels for the comparison of fibrinogen and fibrin units using different D-dimer kits to diagnose VTE. Clin Appl Thromb Hemost. 2018;24:655–62.

    Article  CAS  Google Scholar 

  15. Connolly GC, Dalal M, Lin J, Khorana AA. Incidence and predictors of venous thromboembolism (VTE) among ambulatory patients with lung cancer. Lung Cancer. 2012;78:253–8.

    Article  CAS  Google Scholar 

  16. Zhang Y, Yang Y, Chen W, Guo L, Liang L, Zhai Z, et al. Prevalence and associations of VTE in patients with newly diagnosed lung cancer. Chest. 2014;146:650–8.

    Article  Google Scholar 

  17. Tanizawa Y, Bando E, Kawamura T, Tokunaga M, Makuuchi R, Iida K, et al. Prevalence of deep venous thrombosis detected by ultrasonography before surgery in patients with gastric cancer: a retrospective study of 1140 consecutive patients. Gastric Cancer. 2017;20:878–86.

    Article  Google Scholar 

  18. Zacharia BE, Kahn S, Bander ED, Cederquist GY, Cope WP, McLaughlin L, et al. Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis. J Neurosurg Spine. 2017;27:189–97.

    Article  Google Scholar 

  19. Gainsbury ML, Erdrich J, Taubman D, Mirocha J, Manguso N, Amersi F, et al. Prevalence and predictors of preoperative venous thromboembolism in asymptomatic patients undergoing major oncologic surgery. Ann Surg Oncol. 2018;25:1640–5.

    Article  Google Scholar 

  20. Fowkes FJ, Price JF, Fowkes FG. Incidence of diagnosed deep vein thrombosis in the general population: systematic review. Eur J Vasc Endovasc Surg. 2003;25:1–5.

    Article  CAS  Google Scholar 

  21. Trinchero A, Scheres LJJ, Prochaska JH, Ambaglio C, Wild PS, Middeldorp S, et al. Sex-specific differences in the distal versus proximal presenting location of acute deep vein thrombosis. Thromb Res. 2018;172:74–9.

    Article  CAS  Google Scholar 

  22. Palareti G. How I treat isolated distal deep vein thrombosis (IDDVT). Blood. 2014;123:1802–9.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Toshiki Takemoto.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or an approved substitute was obtained from all patients included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 23 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Takemoto, T., Soh, J., Ohara, S. et al. The prevalence and risk factors associated with preoperative deep venous thrombosis in lung cancer surgery. Surg Today 51, 1480–1487 (2021). https://doi.org/10.1007/s00595-021-02243-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-021-02243-3

Keywords

Navigation