Prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imaging
Abstract Background Venous thromboembolism (VTE) is a major complication in patients with malignant tumors and orthopedic disorders. Although it is known that patients undergoing surgery for malignant musculoskeletal tumor are at an increased risk of thromboembolic events, only few studies have inve...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | Thrombosis Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12959-022-00382-2 |
| _version_ | 1828839564287934464 |
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| author | Kenta Hayashida Yusuke Kawabata Keiju Saito Shintaro Fujita Hyonmin Choe Ikuma Kato Masanobu Takeyama Yutaka Inaba |
| author_facet | Kenta Hayashida Yusuke Kawabata Keiju Saito Shintaro Fujita Hyonmin Choe Ikuma Kato Masanobu Takeyama Yutaka Inaba |
| author_sort | Kenta Hayashida |
| collection | DOAJ |
| description | Abstract Background Venous thromboembolism (VTE) is a major complication in patients with malignant tumors and orthopedic disorders. Although it is known that patients undergoing surgery for malignant musculoskeletal tumor are at an increased risk of thromboembolic events, only few studies have investigated this risk in detail. Therefore, the aim of this study was to determine the prevalence and risk factors for preoperative VTE in malignant musculoskeletal tumors patients. Methods We retrospectively reviewed the medical records of 270 patients who underwent surgical procedures, including biopsy for malignant musculoskeletal tumor, have undergone measurements of preoperative D-dimer levels, and were subsequently screened for VTE by lower extremity venous ultrasonography and/or contrast-enhanced computed tomography scans. Statistical analyses were performed to examine the prevalence and risk factors for VTE. Receiver operating characteristic (ROC) analysis was performed to verify the D-dimer cutoff value for the diagnosis of VTE. Results Overall, 199 patients (103 with primary soft tissue sarcomas, 38 with primary bone sarcomas, 46 with metastatic tumors, and 12 with hematologic malignancies) were included. D-dimer levels were high in 79 patients; VTE was detected in 19 patients (9.5%). Multivariate analysis indicated that age ≥ 60 years (P = 0.021) and tumor location in the lower limbs (P = 0.048) were independent risk factors for VTE. ROC analysis showed that the D-dimer cutoff value for the diagnosis of VTE was 1.53 µg/mL; the sensitivity and specificity were 89.5% and 79.4%, respectively. Conclusions Our study indicated that age and tumor location in the lower limbs were independent risk factors for preoperative VTE in malignant musculoskeletal tumors patients. D-dimer levels were not associated with VTE in the multivariate analysis, likely because they are affected by a wide variety of conditions, such as malignancy and aging. D-dimer is useful for exclusion diagnosis because of its high sensitivity, but patients with high age and tumor location in the lower limbs are a high-risk group and should be considered for imaging evaluation such as ultrasonography regardless of D-dimer levels. Trial registration Our study was approved by the institutional review board. The registration number is B200600056 . The registration date was July 13, 2020. |
| first_indexed | 2024-12-12T19:25:25Z |
| format | Article |
| id | doaj.art-a9f374bf27454789b7d50a1ae42b04a1 |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-12-12T19:25:25Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-a9f374bf27454789b7d50a1ae42b04a12022-12-22T00:14:31ZengBMCThrombosis Journal1477-95602022-04-012011810.1186/s12959-022-00382-2Prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imagingKenta Hayashida0Yusuke Kawabata1Keiju Saito2Shintaro Fujita3Hyonmin Choe4Ikuma Kato5Masanobu Takeyama6Yutaka Inaba7Department of Orthopaedic Surgery, Yokohama City UniversityDepartment of Orthopaedic Surgery, Yokohama City UniversityDepartment of Orthopaedic Surgery, Yokohama City UniversityDepartment of Orthopaedic Surgery, Yokohama City UniversityDepartment of Orthopaedic Surgery, Yokohama City UniversityDepartment of Molecular Pathology, Yokohama City UniversityDepartment of Orthopaedic Surgery, Yokohama City UniversityDepartment of Orthopaedic Surgery, Yokohama City UniversityAbstract Background Venous thromboembolism (VTE) is a major complication in patients with malignant tumors and orthopedic disorders. Although it is known that patients undergoing surgery for malignant musculoskeletal tumor are at an increased risk of thromboembolic events, only few studies have investigated this risk in detail. Therefore, the aim of this study was to determine the prevalence and risk factors for preoperative VTE in malignant musculoskeletal tumors patients. Methods We retrospectively reviewed the medical records of 270 patients who underwent surgical procedures, including biopsy for malignant musculoskeletal tumor, have undergone measurements of preoperative D-dimer levels, and were subsequently screened for VTE by lower extremity venous ultrasonography and/or contrast-enhanced computed tomography scans. Statistical analyses were performed to examine the prevalence and risk factors for VTE. Receiver operating characteristic (ROC) analysis was performed to verify the D-dimer cutoff value for the diagnosis of VTE. Results Overall, 199 patients (103 with primary soft tissue sarcomas, 38 with primary bone sarcomas, 46 with metastatic tumors, and 12 with hematologic malignancies) were included. D-dimer levels were high in 79 patients; VTE was detected in 19 patients (9.5%). Multivariate analysis indicated that age ≥ 60 years (P = 0.021) and tumor location in the lower limbs (P = 0.048) were independent risk factors for VTE. ROC analysis showed that the D-dimer cutoff value for the diagnosis of VTE was 1.53 µg/mL; the sensitivity and specificity were 89.5% and 79.4%, respectively. Conclusions Our study indicated that age and tumor location in the lower limbs were independent risk factors for preoperative VTE in malignant musculoskeletal tumors patients. D-dimer levels were not associated with VTE in the multivariate analysis, likely because they are affected by a wide variety of conditions, such as malignancy and aging. D-dimer is useful for exclusion diagnosis because of its high sensitivity, but patients with high age and tumor location in the lower limbs are a high-risk group and should be considered for imaging evaluation such as ultrasonography regardless of D-dimer levels. Trial registration Our study was approved by the institutional review board. The registration number is B200600056 . The registration date was July 13, 2020.https://doi.org/10.1186/s12959-022-00382-2Preoperative venous thromboembolismVTEDeep vein thrombosisDVTMalignant musculoskeletal tumorMalignant musculoskeletal tumor |
| spellingShingle | Kenta Hayashida Yusuke Kawabata Keiju Saito Shintaro Fujita Hyonmin Choe Ikuma Kato Masanobu Takeyama Yutaka Inaba Prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imaging Thrombosis Journal Preoperative venous thromboembolism VTE Deep vein thrombosis DVT Malignant musculoskeletal tumor Malignant musculoskeletal tumor |
| title | Prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imaging |
| title_full | Prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imaging |
| title_fullStr | Prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imaging |
| title_full_unstemmed | Prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imaging |
| title_short | Prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors: an analysis based on D-dimer screening and imaging |
| title_sort | prevalence and risk factors of preoperative venous thromboembolism in patients with malignant musculoskeletal tumors an analysis based on d dimer screening and imaging |
| topic | Preoperative venous thromboembolism VTE Deep vein thrombosis DVT Malignant musculoskeletal tumor Malignant musculoskeletal tumor |
| url | https://doi.org/10.1186/s12959-022-00382-2 |
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