Analysis Of Risk Factors Of Venous Thromboembolism In Patients With Lung Cancer After Surgery

Objective:This study aimed to analyze the occurrence and risk factors of venous thromboembolism in patients with lung cancer after surgery.Methods:This study was a single-center study.Patients with lung cancer who underwent surgical treatment at the Department of Thoracic Surgery of Cangzhou People’s Hospital from June 2016 to July 2020 were selected.Patients were divided into thrombotic group and non-thrombotic group according to whether venous thromboembolism occurred after the operation.The clinical data of the two groups were analyzed,and the variables with statistical differences in the univariate analysis were included in the multivariate Logistic regression.For the independent variables entering the regression equation,receiver operating characteristic(ROC)curves were used to analyze the effectiveness of various indicators in diagnosing postoperative venous thromboembolism in patients with lung cancer.Results:A total of 354 patients undergoing lung cancer surgery were enrolled in this study,of which 50 patients experienced venous thromboembolism after surgery,the incidence rate was 14.12%(50/354).Univariate analysis showed that age,body mass index(BMI),first second forced expiratory volume(FEV1),carcinoembryonic antigen(CEA),prothrombin time(PT),prothrombin activity(PTA)and surgical methods were statistically different between the two groups(P<0.05),and there were no statistical differences in other indicators.The results of multivariate logistic regression analysis showed that the independent risk factors for venous thromboembolism after lung cancer patients were:BMI(OR=0.685,P=0.028),FEV1(OR=1.903,P=0.028),CEA(OR=0.941,P=0.021),surgical method(OR=0.127,P=0.038).In the analysis of surgical methods,the incidence of venous thromboembolism after thoracoscopic lung cancer resection was 13.54%(47/347),which was significantly lower than that of thoracotomy(42.86%,3/7),and there was a statistical difference(P=0.022).In ROC curve analysis,the area under the ROC curve of BMI in the diagnosis of venous thromboembolism after lung cancer resection was 0.621,and when the cutoff value was 22.55kg/m~2,the diagnostic sensitivity and specificity were 64%and 59.2%,respectively.The area under the ROC curve of FEV1 in the diagnosis of venous thromboembolism after lung cancer resection was 0.628,and when the cutoff value was 2.625L,the diagnostic sensitivity and specificity were 90%and 31.6%,respectively.The area under the ROC curve of CEA in the diagnosis of venous thromboembolism after lung cancer resection was 0.623,and when the cutoff value was 4.95ng/ml,the diagnostic sensitivity and specificity were 38%and 85.5%,respectively.Conclusion:BMI,FEV1,CEA,and surgical methods are independent risk factors for the occurrence of postoperative venous thromboembolism in patients with lung cancer.Patient with lung cancer whose BMI is higher than 22.55kg/m~2,CEA is higher than 4.95ng/ml,FEV1 is lower than 2.625L or undergo thoracotomy has a significantly increased risk of occurrence of postoperative venous thromboembolism.Early monitoring and regular ultrasound review should be performed.If necessary,preventive anticoagulation measures can be taken as soon as possible.