Risk factors for incident venous thromboembolism in patients with renal tumor and inferior vena cava tumor thrombus: a retrospective case–control study

Author:

Wang Hanfeng1,Chen Xinran2,Wang Kailong2,Cao Wenzhe3,Huang Qingbo1,Peng Cheng1,Jia Tongyu1,Liang Qiyang2,Wang Baojun1,Gu Liangyou1,Zhang Xu1,Ma Xin1

Affiliation:

1. Department of Urology, The Third Medical Center, Chinese PLA General Hospital

2. Medical School of Chinese PLA, Beijing

3. School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, Guangdong, People’s Republic of China

Abstract

Background: Venous thromboembolism (VTE) is a principal cause of mortality and adverse oncologic outcomes in patients with renal tumor and inferior vena cava tumor thrombus (RT-IVCTT). However, the preoperative thrombotic risk factors in these patients remain not fully characterized. Objectives: To identify preoperative thrombotic risk factors in patients with RT-IVCTT. Patients/Methods: Two hundred fifty-seven consecutive postsurgical patients with RT-IVCTT aged 18–86 years were enrolled between January 2008 and September 2022. Clinicopathological variables were retrospectively reviewed. A multivariate logistic regression model was performed. Preoperative hemoglobin, neutrophils, and serum albumin levels were analyzed as both continuous and categorical variables. Results: VTE was identified in 63 patients (24.5%). On both continuously and categorically coded variables, advanced IVC thrombus (OR 3.2, 95% CI: 1.4–7.0; OR 2.7, 95% CI: 1.2–6.1), renal sinus fat invasion (OR 3.4, 95% CI: 1.6–7.0; OR 3.7, 95% CI: 1.8–7.7), IVC wall invasion (OR 3.6, 95% CI: 1.6–7.9; OR 4.3, 95% CI: 1.9–10.0), IVC blockage status of greater than 75% (OR 5.2, 95% CI: 1.7–15.8; OR 6.1, 95% CI: 1.9–19.7), and higher neutrophils (OR 1.3, 95% CI: 1.0–1.7; OR 2.4, 95% CI: 1.1–5.4) were significantly associated with increased VTE risk in patients with RT-IVCTT. Except hemoglobin, categorically coded serum albumin (OR 0.36, 95% CI: 0.17–0.75) was validated as an independent risk factor for VTE. Conclusions: This study provided an insight of risk factors contributing to preoperative VTE in patients with RT-IVCTT, which may be beneficial for optimizing strategies to manage VTE in clinical practice.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

General Medicine,Surgery

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