Abstract
Deep vein thrombosis (DVT) is a common but unpredictable complication of surgical interventions. To reveal an association between the blood clot contraction (retraction) and the incidence of postoperative venous thrombosis, 78 patients with brain tumors that were operated on were studied, of which 23 (29%) were diagnosed with postoperative DVT. A clot contraction assay, along with other hemostatic and hematologic tests, was performed 1–3 days before the surgery and on the 1st day and 5–7th days after the surgery. On the 1st postoperative day, clot contraction was significantly suppressed in patients who subsequently developed DVT, compared to the patients without DVT. Importantly, this difference was observed at least 5 days before DVT had developed. The weakening of contraction on the 1st postoperative day was more pronounced in the DVT patients with malignant versus benign brain tumors, atherosclerosis, hypertension, as well as in patients receiving steroids before and during the operation. These results indicate that impaired clot contraction in the postoperative period is associated with imminent DVT, suggesting that it is a prothrombotic risk factor and promotional mechanism. The clot contraction assay has a predictive value in assessing the threat of postoperative thrombosis in patients with benign and malignant brain tumors.
Highlights
Deep vein thrombosis (DVT) is a common but unpredictable complication of surgical interventions
On the 1st postoperative day, clot contraction was significantly suppressed in patients with subsequent postoperative thrombosis, compared to the patients without DVT, as judged from statistical hypothesis testing (Fig. 1, Supplementary Table S1) or 95% confidence interval (CI) (Supplementary Fig. S1, Supplementary Table S2)
The significantly reduced contraction in the subgroup of patients with DVT remained 5–7 days after the surgery, at or after the time of DVT development (Fig. 2 and Supplementary Fig. S1, Supplementary Tables S1 and S2), which confirmed the known association of the clot contraction assay with ongoing venous thrombosis[29]
Summary
Deep vein thrombosis (DVT) is a common but unpredictable complication of surgical interventions. The weakening of contraction on the 1st postoperative day was more pronounced in the DVT patients with malignant versus benign brain tumors, atherosclerosis, hypertension, as well as in patients receiving steroids before and during the operation These results indicate that impaired clot contraction in the postoperative period is associated with imminent DVT, suggesting that it is a prothrombotic risk factor and promotional mechanism. Preoperative steroid usage, male gender, and comorbidities can be associated with a high risk of DVT and P E20 In addition to these clinical factors that cannot be used as a reliable and specific predictor for VTE in (neuro)surgical patients, we asked if there were laboratory blood tests that could have a relatively strong and justified predictive value for postoperative DVT, based on the pathogenic mechanisms of thrombosis
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