肺癌切除后静脉血栓栓塞的预测因素
Andrea L Axtell1, Henning A Gaissert1, Xiaodong Bao2
1Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Massachusetts.
The Annals of thoracic surgery
|January 31, 2024
概括
在肺癌手术后确定静脉血栓栓塞 (VTE) 的危险因素至关重要. 黑人种族,间歇性纤维化和晚期疾病增加了静脉瘤风险,需要加强高风险患者的预防措施.
科学领域:
- 心胸外科手术 心胸外科手术
- 手术瘤学手术瘤学
- 血管外科 血管外科
背景情况:
- 静脉血栓塞栓症 (VTE) 是瘤手术后的一个严重并发症,导致患者的发病率和死亡率.
- 确定术后静脉瘤风险因素对于优化癌症患者的预防策略至关重要.
研究的目的:
- 在接受肺癌切除的患者中识别术后风险因素VTE.
- 定义高风险患者群体,他们可能受益于加强对VTE的预防措施.
主要方法:
- 在2009年至2021年期间,对57531名接受肺癌切除术的患者进行了回顾性队列分析.
- 术后肺栓塞 (PE) 或深静脉血栓塞 (DVT) 的患者和没有患者之间的基线特征和结果的比较.
- 多变量回归分析以确定术后静脉瘤的独立预测因子.
主要成果:
- 手术后PE发生在1.3%的患者中.
- 较高的PE风险与黑人种族,间歇性纤维化,先前的VTE,局部晚期疾病,双眼切除术和肺切除术有关.
- 风险因素包括黑人种族 (OR 1.74),间歇性纤维化 (OR 1.77),切除程度和更长的手术时间;微创手术具有保护性.
结论:
- 黑人种族,间歇性纤维化和晚期疾病等不可修改的危险因素是术后PE的关键预测因素.
- 与静脉瘤相关的死亡率增加凸显了在确定高风险的外科瘤患者队伍中加强外科期间预防的需要.
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