High preoperative D-dimer increases the risk of venous thromboembolism after gynecological tumor surgeries: a meta-analysis of cohort studies

IF 3.4 3区 医学 Q2 HEMATOLOGY
Zeyu Meng , Lu Liu , Xu Yang , Xingxu Hu , Yaping Xi , Qinglin Yang , Yun Luo , Donghong Wang , Jun Liu
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Abstract

The role of preoperative D-dimer in the prediction of postoperative venous thromboembolism (VTE) with gynecological tumor remains unclear. This meta-analysis sought to assess the association between preoperative D-dimer and the risk of VTE after gynecological tumor surgeries and to identify prognostic significance of D-dimer in the prediction of postoperative VTE. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Eight electronic databases were searched for cohort studies from the date of inception to April 2024. The Newcastle-Ottawa Scale scoring tool and the Risk of Bias in Non-Randomized Studies–Intervention tool were used to assess the quality of the literature and the risk of bias in cohort studies, respectively. The relative risk and 95% CIs of the highest vs the lowest category and per milligram per liter of D-dimer were pooled relative to the VTE risk after gynecological tumor surgeries. Fifteen studies that met the criteria were included. Among these studies, D-dimer was considered as a continuous variable in 8 studies. The random-effect model results showed that the VTE risk was increased by 42% (15%-69%) per milligram per liter increase in D-dimer. Furthermore, based on the cutoff thresholds of D-dimer, 7 studies that reported the effect estimates of postoperative VTE in women with gynecological tumor by D-dimer were categorized as binary variables. Compared with the reference levels, the pooled relative risk of VTE after gynecological tumor surgeries for the higher level was 2.58 (95% CI, 1.49-4.47). Elevated preoperative D-dimer was associated with higher VTE risks after gynecological tumor surgeries.
术前高d -二聚体增加妇科肿瘤手术后静脉血栓栓塞的风险:队列研究的荟萃分析
术前d -二聚体在预测妇科肿瘤术后静脉血栓栓塞(VTE)中的作用尚不清楚。本荟萃分析旨在评估术前d -二聚体与妇科肿瘤手术后静脉血栓栓塞风险之间的关系,并确定d -二聚体在预测术后静脉血栓栓塞中的预后意义。本研究是根据2020年系统评价和荟萃分析的首选报告项目进行的。从建立之日到2024年4月,检索了8个电子数据库的队列研究。纽卡斯尔-渥太华量表评分工具和非随机研究的偏倚风险干预工具分别用于评估文献质量和队列研究的偏倚风险。相对于妇科肿瘤手术后静脉血栓栓塞的风险,将最高和最低类别以及每毫克每升d -二聚体的相对风险和95% ci进行汇总。15项符合标准的研究被纳入。在这些研究中,有8项研究将d -二聚体视为连续变量。随机效应模型结果显示,d -二聚体每增加1毫克/升,静脉血栓栓塞风险增加42%(15%-69%)。此外,基于d -二聚体的截止阈值,将7篇报道了d -二聚体对妇科肿瘤女性术后静脉血栓栓塞效果估计的研究归为二元变量。与参考水平相比,较高水平的妇肿瘤手术后静脉血栓栓塞的总相对危险度为2.58 (95% CI, 1.49-4.47)。术前d -二聚体升高与妇科肿瘤手术后静脉血栓栓塞风险增高有关。
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来源期刊
CiteScore
5.60
自引率
13.00%
发文量
212
审稿时长
7 weeks
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