Analysis of the relationship between venous thromboembolism after surgical treatment for bronchiectasis and preoperative hemoglobin amount_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CAI Yongsheng , CHEN Qingshan , DONG Honghong , CHEN Shuo , LI Xin , YE Xin , FU Yili , CHEN Qirui , YOU Bin ,  MIAO Jinbai , LI Hui , HU Bin

Department of Thoracic Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing Institute of Respiratory Diseases, Beijing, 100020, P. R. China;

Corresponding author：

MIAO Jinbai, Email: miaojinbai@ccmu.edu.cn

Keywords：

Bronchiectasis; surgery; venous thromboembolism; hemoglobin; D-dimer

DOI：

10.7507/1007-4848.202201073

Video：

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Objective To study the correlation of preoperative hemoglobin amount with venous thromboembolism (VTE) after surgical treatment of bronchiectasis and the clinical significance. Methods A retrospective study was performed on patients with bronchiectasis who underwent surgical treatment in our center from June 2017 to November 2021. The differences in blood parameters between the VTE patients and non-VTE patients were compared. The relationship between preoperative hemoglobin and VTE was confirmed by quartile grouping and receiver operating characteristic (ROC) curve. Results A total of 122 patients were enrolled, including 50 males and 72 females, with a mean age of 52.52±12.29 years. The overall incidence of VTE after bronchiectasis was 9.02% (11/122). Preoperative hemoglobin amount (OR=0.923, 95%CI 0.870-0.980, P=0.008) and D-dimer amount (OR=1.734, 95%CI 1.087-2.766, P=0.021) were independent influencing factors for VTE after bronchiectasis. The incidence of VTE after bronchiectasis decreased gradually with the increase of preoperative hemoglobin amount. The area under the ROC curve (AUC) of postoperative D-dimer alone was 0.757, whereas the AUC of postoperative D-dimer combined with preoperative hemoglobin amount was 0.878. Conclusion Low preoperative hemoglobin is an independent risk factor for postoperative VTE. Postoperative D-dimer combined with preoperative hemoglobin amount has a better predictive performance compared with postoperative D-dimer alone for postoperative VTE.

Citation： CAI Yongsheng, CHEN Qingshan, DONG Honghong, CHEN Shuo, LI Xin, YE Xin, FU Yili, CHEN Qirui, YOU Bin, MIAO Jinbai, LI Hui, HU Bin. Analysis of the relationship between venous thromboembolism after surgical treatment for bronchiectasis and preoperative hemoglobin amount. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(11): 1561-1566. doi: 10.7507/1007-4848.202201073 Copy

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2.	van Aken BE, den Heijer M, Bos GM, et al. Recurrent venous thrombosis and markers of inflammation. Thromb Haemost, 2000, 83(4): 536-539.
3.	Hachey KJ, Sterbling H, Choi DS, et al. Prevention of postoperative venous thromboembolism in thoracic surgical patients: Implementation and evaluation of a Caprini risk assessment protocol. J Am Coll Surg, 2016, 222(6): 1019-1027.
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6.	李树灏, 张堃, 宋哲, 等. 血红蛋白量与下肢骨折下肢深静脉血栓形成发生率的关系分析. 中华创伤骨科杂志, 2021, 23(10): 864-870.
7.	Folsom AR, Wang W, Parikh R, et al. Hematocrit and incidence of venous thromboembolism. Res Pract Thromb Haemost, 2020, 4(3): 422-428.
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16.	王延风, 马飞, 刘斌亮, 等. 基于COMPASS-CAT风险评估模型的非小细胞肺癌患者静脉血栓栓塞症风险预测. 中华肿瘤杂志, 2020, 42(4): 340-345.
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18.	Chi G, Gibson CM, Hernandez AF, et al. Association of anemia with venous thromboembolism in acutely ill hospitalized patients: An APEX trial substudy. Am J Med, 2018, 131(8): 972.e1-972.e7.
19.	Sergueeva A, Miasnikova G, Shah BN, et al. Prospective study of thrombosis and thrombospondin-1 expression in Chuvash polycythemia. Haematologica, 2017, 102(5): e166-e169.
20.	Franchini M, Targher G, Montagnana M, et al. Iron and thrombosis. Ann Hematol, 2008, 87(3): 167-173.
21.	Piety NZ, Reinhart WH, Pourreau PH, et al. Shape matters: The effect of red blood cell shape on perfusion of an artificial microvascular network. Transfusion, 2016, 56(4): 844-851.
22.	Bohlius J, Wilson J, Seidenfeld J, et al. Recombinant human erythropoietins and cancer patients: Updated meta-analysis of 57 studies including 9353 patients. J Natl Cancer Inst, 2006, 98(10): 708-714.
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24.	Griesshammer M, Kiladjian JJ, Besses C. Thromboembolic events in polycythemia vera. Ann Hematol, 2019, 98(5): 1071-1082.
25.	Cui S, Chen S, Li H, et al. Risk factors for venous thromboembolism and evaluation of the modified Caprini score in patients undergoing lung resection. J Thorac Dis, 2020, 12(9): 4805-4816.
26.	Shi A, Huang J, Wang X, et al. Postoperative D-dimer predicts venous thromboembolism in patients undergoing urologic tumor surgery. Urol Oncol, 2018, 36(6): 307.e15-307.e21.
27.	Prell J, Rachinger J, Smaczny R, et al. D-dimer plasma level: A reliable marker for venous thromboembolism after elective craniotomy. J Neurosurg, 2013, 119(5): 1340-1346.

1. Rodrigues CA, Ferrarotto R, Kalil Filho R, et al. Venous thromboembolism and cancer: A systematic review. J Thromb Thrombolysis, 2010, 30(1): 67-78.
2. van Aken BE, den Heijer M, Bos GM, et al. Recurrent venous thrombosis and markers of inflammation. Thromb Haemost, 2000, 83(4): 536-539.
3. Hachey KJ, Sterbling H, Choi DS, et al. Prevention of postoperative venous thromboembolism in thoracic surgical patients: Implementation and evaluation of a Caprini risk assessment protocol. J Am Coll Surg, 2016, 222(6): 1019-1027.
4. Pabinger I, Thaler J, Ay C. Biomarkers for prediction of venous thromboembolism in cancer. Blood, 2013, 122(12): 2011-2018.
5. Khorana AA, Kuderer NM, Culakova E, et al. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood, 2008, 111(10): 4902-4907.
6. 李树灏, 张堃, 宋哲, 等. 血红蛋白量与下肢骨折下肢深静脉血栓形成发生率的关系分析. 中华创伤骨科杂志, 2021, 23(10): 864-870.
7. Folsom AR, Wang W, Parikh R, et al. Hematocrit and incidence of venous thromboembolism. Res Pract Thromb Haemost, 2020, 4(3): 422-428.
8. Khorana AA, Francis CW, Culakova E, et al. Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study. Cancer, 2005, 104(12): 2822-2829.
9. 支气管扩张症专家共识撰写协作组, 中华医学会呼吸病学分会感染学组. 中国成人支气管扩张症诊断与治疗专家共识. 中华结核和呼吸杂志, 2021, 44(4): 311-321.
10. Seitz AE, Olivier KN, Adjemian J, et al. Trends in bronchiectasis among medicare beneficiaries in the United States, 2000 to 2007. Chest, 2012, 142(2): 432-439.
11. Lin JL, Xu JF, Qu JM. Bronchiectasis in China. Ann Am Thorac Soc, 2016, 13(5): 609-616.
12. Polverino E, Goeminne PC, McDonnell MJ, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J, 2017, 50(3): 1700629.
13. Song C, Shargall Y, Li H, et al. 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. Eur J Cardiothorac Surg, 2019, 55(3): 455-460.
14. Theochari NA, Theochari CA, Kokkinidis DG, et al. Venous thromboembolism after esophagectomy for cancer: A systematic review of the literature to evaluate incidence, risk factors, and prophylaxis. Surg Today, 2022, 52(2): 171-181.
15. Gould MK, Garcia DA, Wren SM, 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(2 Suppl): e227S-e277S.
16. 王延风, 马飞, 刘斌亮, 等. 基于COMPASS-CAT风险评估模型的非小细胞肺癌患者静脉血栓栓塞症风险预测. 中华肿瘤杂志, 2020, 42(4): 340-345.
17. Starling N, Rao S, Cunningham D, et al. Thromboembolism in patients with advanced gastroesophageal cancer treated with anthracycline, platinum, and fluoropyrimidine combination chemotherapy: A report from the UK National Cancer Research Institute Upper Gastrointestinal Clinical Studies Group. J Clin Oncol, 2009, 27(23): 3786-3793.
18. Chi G, Gibson CM, Hernandez AF, et al. Association of anemia with venous thromboembolism in acutely ill hospitalized patients: An APEX trial substudy. Am J Med, 2018, 131(8): 972.e1-972.e7.
19. Sergueeva A, Miasnikova G, Shah BN, et al. Prospective study of thrombosis and thrombospondin-1 expression in Chuvash polycythemia. Haematologica, 2017, 102(5): e166-e169.
20. Franchini M, Targher G, Montagnana M, et al. Iron and thrombosis. Ann Hematol, 2008, 87(3): 167-173.
21. Piety NZ, Reinhart WH, Pourreau PH, et al. Shape matters: The effect of red blood cell shape on perfusion of an artificial microvascular network. Transfusion, 2016, 56(4): 844-851.
22. Bohlius J, Wilson J, Seidenfeld J, et al. Recombinant human erythropoietins and cancer patients: Updated meta-analysis of 57 studies including 9353 patients. J Natl Cancer Inst, 2006, 98(10): 708-714.
23. Tanaka T, Nangaku M. Recent advances and clinical application of erythropoietin and erythropoiesis-stimulating agents. Exp Cell Res, 2012, 318(9): 1068-1073.
24. Griesshammer M, Kiladjian JJ, Besses C. Thromboembolic events in polycythemia vera. Ann Hematol, 2019, 98(5): 1071-1082.
25. Cui S, Chen S, Li H, et al. Risk factors for venous thromboembolism and evaluation of the modified Caprini score in patients undergoing lung resection. J Thorac Dis, 2020, 12(9): 4805-4816.
26. Shi A, Huang J, Wang X, et al. Postoperative D-dimer predicts venous thromboembolism in patients undergoing urologic tumor surgery. Urol Oncol, 2018, 36(6): 307.e15-307.e21.
27. Prell J, Rachinger J, Smaczny R, et al. D-dimer plasma level: A reliable marker for venous thromboembolism after elective craniotomy. J Neurosurg, 2013, 119(5): 1340-1346.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Analysis of the relationship between venous thromboembolism after surgical treatment for bronchiectasis and preoperative hemoglobin amount

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