Risk Factors For Vascular Events In Patients With Calf Muscular Venous Thrombosis Before Urological Surgery

Objective:The aim of this study was to investigate the incidence and risk factors of thromboembolism(VTE)in urological patients with preoperative CMVT by reviewing the clinical data of patients with preoperative diagnosis of calf intermuscular venous thrombosis(CMVT)in the Department of Urology,the First Hospital of Shanxi Medical University,and to propose a targeted clinical prevention and treatment plan to reduce the occurrence of postoperative serious vascular events in patients with CMVT.Methods:The clinical data of 95 patients with preoperative confirmed CMVT and 10 of them with DVT and 2 with PE in the Department of Urology,the First Hospital of Shanxi Medical University between November 2019 and November 2021 were retrospectively analyzed.They were divided into two groups: embolization group: lower leg intermuscular venous thrombosis spread to the peroneal vein,posterior vein,femoral vein or iliac vein,or PE;control group: the remaining lower leg intermuscular venous thrombosis.All patients underwent lower limb Doppler color ultrasound(CDFI)after admission.For patients with suspected deep venous thrombosis symptoms such as lower limb swelling and pain during hospitalization,lower limb vascular color Doppler ultrasound was performed again to determine whether there was deep venous thrombosis;for patients with chest tightness,suffocation,cough and other symptoms,pulmonary CT angiography was performed to determine whether there was pulmonary embolism.(1)To determine the incidence of concurrent VTE in CMVT patients;(2)To analyze the influence of anticoagulation,operation position,operation time and other factors on patients with CMVT complicated with VTE;(3)To analyze the influence of general conditions and underlying diseases on VTE in CMVT patients.Collect patient information,including age,gender,BMI(body mass index),history of hypertension,history of diabetes,history of coronary atherosclerotic heart disease,history of chronic obstructive pulmonary disease(COPD),history of smoking,history of cancer,operation time,and operation position.Statistical SPSS 26.0 software was applied to analyze each observed variable,and variables that underwent univariate analysis and were significant(P < 0.05)were included in the multivariate analysis and analyzed using binary logistic regression.Results:T The incidence of VTE in patients with CMVT before urological surgery was12.6%;there was a significant difference between the anticoagulant therapy without anticoagulant therapy groups.Univariate statistical analysis showed that the age,history of hypertension,history of COPD,presence of tumor,and operation time of the patients were significantly different between the two groups(P < 0.05),while the gender,BMI,history of diabetes,history of coronary atherosclerotic heart disease,smoking history,and operation position were not significantly different between the two groups(P > 0.05);Multivariate Logistic regression analysis showed that age(OR=1.135,95%CI=1.010-1.276,P=0.034),hypertension(OR=4.095,95%CI= 1.033-16.223,P=0.045),complicated tumor(OR=3.982,95%CI= 1.011-15.680,P=0.048)was an independent risk factor for CMVT complicated with VTE.Conclusion:(1)The incidence of PE was 2.1% and the incidence of DVT was 10.5% in patients with CMVT before urological surgery;the incidence of VTE was 12.6% in patients with CMVT before urological surgery;(2)Anticoagulation therapy could significantly reduce the risk of VTE in patients with CMVT before urological surgery;(3)Advanced age,history of hypertension,operation time greater than 2 hours,and tumor were risk factors for VTE in patients with CMVT before urological surgery...