Incidence and Risk Factors Related to Symptomatic Venous Thromboembolic Events After Esophagectomy for Cancer.

Details

Serval ID
serval:BIB_655F2713AD98
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Incidence and Risk Factors Related to Symptomatic Venous Thromboembolic Events After Esophagectomy for Cancer.
Journal
The Annals of thoracic surgery
Author(s)
Mantziari S., Gronnier C., Pasquer A., Gagnière J., Théreaux J., Demartines N., Schäfer M., Mariette C.
Working group(s)
FREGAT Working Group–FRENCH–AFC
Contributor(s)
Dhahri A., Lignier D., Cossé C., Regimbeau J.M., Luc G., Collet D., Cabau M., Jougon J., Badic B., Lozach P., Bail J.P., Cappeliez S., El Nakadi I., Lebreton G., Alves A., Flamein R., Pezet D., Pipitone F., Stan-Iuga B., Coueffé X., Contival N., Pappalardo E., Msika S., Hec F., Vanderbeken M., Tessier W., Briez N., Fredon F., Gainant A., Mathonnet M., Bigourdan J.M., Mezoughi S., Ducerf C., Baulieux J., Mabrut J.Y., Pasquer A., Baraket O., Poncet G., Adam M., Vaudoyer D., Enfer P.J., Villeneuve L., Glehen O., Coste T., Fabre J.M., Marchal F., Frisoni R., Ayav A., Brunaud L., Bresler L., Cohen C., Aze O., Venissac N., Pop D., Mouroux J., Donici I., Prudhomme M., Felli E., Lisunfui S., Seman M., Petit G.G., Karoui M., Tresallet C., Ménégaux F., Vaillant J.C., Hannoun L., Malgras B., Lantuas D., Pautrat K., Pocard M., Valleur P., Lefevre J., Chafai N., Balladur P., Lefranéois M., Parc Y., Paye F., Tiret E., Nedelcu M., Laface L., Perniceni T., Gayet B., Turner K., Meunier B., Filipello A., Porcheron J., Tiffet O., Kamlet N., Chemaly R., Klipfel A., Pessaux P., Brigand C., Rohr S., Chalret du Rieu M., Carrére N., Da Re C., Dumont F., Goéré D., Elias D., Bertrand C.
ISSN
1552-6259 (Electronic)
ISSN-L
0003-4975
Publication state
Published
Issued date
04/2016
Peer-reviewed
Oui
Volume
102
Number
3
Pages
979-984
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
Major oncologic surgery is associated with a high incidence of venous thromboembolic events (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE). However, the incidence and risk factors for symptomatic VTE during curative treatment for patients with esophageal cancer are poorly documented.
Data were collected from 30 European centers from 2000 to 2010. The incidence of in-hospital VTE was assessed in 2,944 patients with esophageal cancer having surgery with curative intent, and 50 clinically relevant parameters were assessed as potential risk factors for VTE. Patients received low molecular weight heparin prophylaxis during hospital stay and for 4 weeks after surgery.
Eighty-four patients (2.9%) developed a symptomatic VTE; all of them had a DVT and 44 were also diagnosed with a PE. In the VTE group there were 19 postoperative deaths recorded, 5 of which (26.3%) were directly caused by PE at postoperative days 7, 10, 21, 45, and 48 despite VTE prophylaxis. In-hospital postoperative mortality was significantly higher in VTE patients (23% versus 7%, p < 0.001) and mean hospital stay was also longer in this group (33 ± 24 versus 25 ± 21 days, p < 0.001). Multivariable analysis showed that high American Society of Anesthesiologists (ASA) class (p = 0.008), pneumopathy (p = 0.002), or an acute respiratory distress syndrome (ARDS) (p = 0.015) were significantly associated with VTE.
Patients with ASA class III or IV and those who present a postoperative pneumopathy or ARDS seem to be at higher risk for VTE. Thus, current VTE screening and thromboprophylaxis for these patients might be inadequate and needs further investigation.

Keywords
Adult, Aged, Aged, 80 and over, Esophageal Neoplasms/surgery, Esophagectomy/adverse effects, Female, Hospital Mortality, Humans, Incidence, Length of Stay, Male, Middle Aged, Postoperative Complications/etiology, Risk Factors, Venous Thromboembolism/epidemiology, Venous Thromboembolism/etiology
Pubmed
Create date
11/04/2017 19:22
Last modification date
20/08/2019 15:21
Usage data