A Retrospective Study On Risk Factors For Deep Venous Thrombosis Of Lower Extremities After Gastrointestinal Tumor Surgery

Objective: This study retrospectively analyzed case data of the gastrointestinal tumor patients who were treated with surgery,aiming to explore risk factors and independent risk factors for deep venous thrombosis of the lower extremities after the surgery.Methods: This study collected 568 cases of the same group in the Department of Gastrointestinal Surgery at Hospital of the Fourth Hospital of Hebei Medical University from January 1,2016 to September 30,2020.Based on the inclusion and exclusion criteria,it included 436 cases for the retrospective analysis,among which 128 cases with deep venous thrombosis of the lower extremities after the surgery were considered as Case Group,and 308 cases without deep venous thrombosis after the surgery were considered as Control Group.And then,univariate analysis and multivariate analysis were performed on the two groups from the three factors: general situations(age,gender,blood type,body mass index,ASA classification,smoking history,drinking history,hypertension,diabetes,coronary heart disease),treatment conditions(lesion location,preoperative neoadjuvant chemotherapy,anesthesia methods,surgical methods,surgical position,surgery time,intraoperative blood transfusion,postoperative destination)and laboratory examinations(D-dimer,PT,APTT,WBC,PLT).For univariate analysis,normal distribution data of the groups was compared by independent samples t-test,non-normal distribution data by non-parametric test(Mann-Whitney U test),and the enumeration data by χ~2 test.For multivariate analysis,binary logistic regression analysis was applied.Results: The univariate analysis showed that age and D-dimer before surgery in Case Group were higher than those in Control Group(P<0.05).The patients with O-type blood,ASA-III,lesion location in gastric area or intraoperative blood transfusion,or who were transferred to intensive care unit after surgery,were more likely to suffer from deep venous thrombosis of lower extremities,which meant there were statistical significances for these factors(P<0.05).But no statistical significance existed(P>0.05)in gender,body mass index,smoking history,drinking history,hypertension,diabetes,coronary heart disease,preoperative neoadjuvant chemotherapy,anesthesia methods,surgical methods,surgical position,surgery time,PT,APTT,WBC and PLT.The multivariate analysis(binary logistic regression analysis)indicated that the differences in old age(OR=2.296,95%CI 1.422～3.705),blood type(OR=1.785,95%C I 1.027～3.106),lesion location(OR=2.008,95%CI 1.201～3.356),postoperative destination(OR=2.520,95%CI 1.252～5.071)and D-dimer(OR=4.957,95%CI 2.754～8.922)exist statistical significance(P<0.05).Conclusions:1.Old age(>65 years old),non-O blood type,lesion location in gastric area,to transfer to intensive care unit after surgery and abnormal D-dimer are the independent risk factors for deep venous thrombosis of lower extremity after gastrointestinal tumor surgery.2.ASA-III and intraoperative blood transfusion are the risk factors,instead of the independent risk factors,for deep venous thrombosis of lower extremities after gastrointestinal tumor surgery.