Analysis Of High-Risk Factors Related With Thrombosis In The Patients With Epithelial Ovarian Carcinoma During Perioperative Period

Objective:Venous thromboembolism（VTE）,including deep venous thrombosis（DVT）and pulmonary embolism（PE）,is a common postoperative complication of gynecological malignancies.By summarizing the perioperative clinical characteristics and occurrence of VTE in patients with primary epithelial ovarian carcinoma（EOC）,the relevant risk factors affecting the occurrence of perioperative VTE in EOC patients were explored to provide theoretical evidence to assist the diagnosis and prevention management of perioperative VTE in EOC patients,further improve diagnostic accuracy of VTE and reduce the incidence of VTE,stengthen the prevention measures,and ultimately improve the quality of life of patients.Methods:A retrospective analysis was conducted on the patients with primary EOC treated in the Department of Obstetrics and Gynecology,Provincial Hospital Affiliated to Anhui Medical University,between January 2017 and July 2019,and relevant medical record information including general characteristics（such as age,height,weight,comorbidities,ect.）,laboratory test results（such as D-dimer,platelets,CA125,ect.）,imaging examiniation results,operation related information,postoperative pathology,ect.,were collected through univariate analysis to determine the risk factors related to VTE.And the ROC curve method was used to evaluate its diagnostic value in predicting VTE,also the independent risk factors affecting the occurrence of VTE were determined by multivariate analysis,and the multivariate analysis results were verified by the bootstrap resampling method.Results:This study included 233 EOC patients,of which 26 patients had VTE rate of 11.16%,9patients had preoperative VTE,16 patients had postoperative VTE,1 patient had VTE events before and after surgery,3 patients had PE only,DVT complicated with PE in 7cases.After univariate analysis,multivariate analysis and bootstrap sample analysis,preoperative D-dimer level（>4.215μg/ml）（P = 0.032）and cerebral infarction（P <0.001）were independent risk factors for preoperative VTE.Age（>50.5 years）（P =0.002）and unsatisfactory cytoreduction（P = 0.002）were independent risk factors for postoperative VTE.Bootstrap analysis also found that preoperative albumin（<39.85g/L）,CA125（>1474U/ml）,clear cell carcinoma,postoperative D-dimer level（>4.71μg/ml）,history of pulmonary tuberculosis were also perioperative VTE risk factors.Conclusion:More effective thromboprophylaxis and preoperative evaluation are necessary in patients with EOC.D-dimer level is an important independent risk factor for perioperative VTE,and patients older than 50 years or who have not achieved satisfactory tumor reduction should be paid more attention to postoperative VET screening and prevention.