[Incidence and influencing factors of venous thromboembolism after lung transplantation]

Zhonghua Yi Xue Za Zhi. 2019 Jun 25;99(24):1848-1852. doi: 10.3760/cma.j.issn.0376-2491.2019.24.003.
[Article in Chinese]

Abstract

Objective: To analyze the incidence and influencing factors of venous thromboembolism (VTE) after lung transplantation. Methods: This study retrospectively analyzed the clinical data of 375 lung transplant patients from January 2015 to December 2017 in Wuxi People's Hospital. Every patient was classified into the VTE group or the non-VTE group according to whether the patient had VTE or not. Basic information like age, type of surgical procedure etc. was compared between two groups. The prevention and treatment of VTE between two groups were also compared. Furthermore, multivariate Logistic regression analysis was used to analyze the influence of related factors on the occurrence of postoperative VTE. Deep venous thrombosis (DVT) was diagnosed with vascular ultrasonography, and pulmonary thromboembolism (PTE) was diagnosed with CT pulmonary angiogram, nuclear ventilation/perfusion scanning, or pulmonary angiography. Results: This study included 316 lung transplant patients. VTE occurred in 19 patients (6.0%) during perioperative and follow-up period. The age of the VTE group was significantly higher than that of the non-VTE group (63.4±11.9 vs 54.3±13.0, P=0.003). The proportion of single lung transplantation in the VTE group was significantly higher than that in the non-VTE group (78.9% vs 48.5%, P=0.010). The incidence of VTE in patients without prevention was significantly higher than that in patients with prevention (15.0% vs 1.9%, P<0.001). Single lung transplantation (OR=4.425, P=0.018), duration in intensive care unit (ICU) (OR=1.396, P=0.001) and age (OR=1.080, P=0.005) were independent risk factors for VTE after lung transplantation. Conclusions: The incidence of VTE after lung transplantation is high. Single lung transplantation, prolonged duration of ICU stay and advanced age increase the risk of VTE after lung transplantation.

目的: 分析肺移植术后静脉血栓栓塞症(VTE)的发生率及影响因素。 方法: 回顾性分析无锡人民医院2015年1月至2017年12月肺移植患者375例的临床资料。根据是否发生VTE将患者分为VTE组和非VTE组,比较两组年龄、手术方式等基本资料以及VTE预防及治疗情况,多因素Logistic回归分析有关因素对术后发生VTE的影响。深静脉血栓形成(DVT)应用血管彩超确诊,肺血栓栓塞症(PTE)应用螺旋CT肺动脉造影(CTPA)、核素肺通气/灌注扫描或肺动脉造影确诊。 结果: 共纳入肺移植患者316例,其中19例(6.0%)在围手术期及随访过程中发生VTE。VTE组年龄显著高于非VTE组(63.4±11.9比54.3±13.0,P=0.003),单肺移植比例显著高于非VTE组(78.9%比48.5%,P=0.010)。术后未预防者VTE发生率显著高于预防者(15.0%比1.9%,P<0.001)。单肺移植(OR=4.425,P=0.018)、住ICU时间(OR=1.396,P=0.001)、年龄(OR=1.080,P=0.005)是肺移植术后发生VTE的独立危险因素。 结论: VTE在肺移植术后发生率高,单肺移植、住ICU时间延长、高龄增加肺移植术后发生VTE的风险。.

Keywords: Disease attributes; Lung transplantation; Pulmonary embolism; Venous thrombosis.

MeSH terms

  • Humans
  • Incidence
  • Lung Transplantation* / adverse effects
  • Pulmonary Embolism*
  • Retrospective Studies
  • Risk Factors
  • Venous Thromboembolism* / etiology