Predictive Value Of Thrombelastography For Perioperative Venous Thromboembolism In Patients With Gynecologic Malignant Tumors

Objective:Venous thromboembolism is a common complication of perioperative patients with gynecologic malignancies.Thrombelastography(TEG)is a technique that can comprehensively reflect blood coagulation and fibrinolysis.The purpose of this study was to investigate whether TEG or conventional coagulation tests have predictive value for the occurrence of venous thromboembolism in patients with gynecologic malignant tumors during perioperative period.METHODS:A total of 102 patients undergoing gynecologic oncology surgery in our hospital from September 2017 to June 2018 were included in this study.The patient data including age,cancer stage,pathological grade,comorbidities,procedure type,preoperative and postoperative TEG and conventional coagulation tests parameters were collected.The t-test and chi-square test were used to compare the differences between patients with venous thromboembolism and those without.Two-category logistic regression was used to analyze the risk factors of venous thromboembolism.The receiver working curve was applied to evaluate the predictive value of thromboelastography and conventional coagulation tests parameters for perioperative venous thromboembolism patients with gynecologic malignant tumors during perioperative period.The Youdan index was used to determine the corresponding cut-off value for each parameter.RESULTS:A total of 9 out of 102 patients developed venous thromboembolism(VTE)with an incidence of 8.8%.The differences of age,staging,postoperative reaction time(R),coagulation index(Cl)and D-Dimer between patients with VTE and patients without VTE were statistically significant(P<0.05).However,the independent risk factors of VTE could not be identified by the further binary logistic regression analysis.The results of the receiver operating curve showed that Cl(95%Cl 0.59-0.94,P=0.02),R(95%Cl 0.56-0.93,P=0.036)and D-Dimer(95%Cl 0.67-0.90,P=0.015)had predictive value for perioperative venous thromboembolism in patients with gynecologic malignancies.The cut-off value for Cl was 2.35,with a sensitivity of 85.7%and a specificity of 79.7%.The cut-off value for R was 5.65mim and the sensitivity and the specificity were 39.1%and 100%respectively.The cut-off value for D-Dimer was 2.26mg/L,which had a sensitivity of 100%and a specificity of 61.1%.Conclusion:R and Cl of thromboelastography and D-dimer have predictive value for venous thromboembolism in perioperative patients with gynecologic malignancies.