Thromboelastography-based dynamic evaluation of perioperative coagulation changes and anticoagulant efficacy in lung cancer patients.

IF 2.6 4区医学 Q2 HEMATOLOGY

Thrombosis Journal Pub Date : 2025-04-10 DOI:10.1186/s12959-025-00718-8

Songping Cui, Ruiheng Jiang, Jiaojie Zhao, Jing Wang, Bin Hu, Hui Li, Shuo Chen

{"title":"Thromboelastography-based dynamic evaluation of perioperative coagulation changes and anticoagulant efficacy in lung cancer patients.","authors":"Songping Cui, Ruiheng Jiang, Jiaojie Zhao, Jing Wang, Bin Hu, Hui Li, Shuo Chen","doi":"10.1186/s12959-025-00718-8","DOIUrl":null,"url":null,"abstract":"Background: Venous thromboembolism (VTE) is a common postoperative complication in oncologic surgery, closely associated with perioperative hypercoagulability. Thromboelastography (TEG) may be an effective method for monitoring hypercoagulability and guiding preventive anticoagulation.Methods: We prospectively collected perioperative clinical data from lung cancer surgery patients at our hospital between June 2019 and January 2020. TEG and coagulation-related indicators were monitored preoperatively, and on postoperative days 1 and 3. Newly diagnosed postoperative VTE was monitored using lower limb color doppler ultrasound.Results: A total of 241 lung cancer surgery patients were included, with 25 developing VTE postoperatively (10.4%). TEG results showed a significant decrease in the R value (a thrombin marker) on postoperative day 1, followed by an increase on day 3. The MA value (a platelet marker) increased postoperatively. D-dimer levels also rose after surgery. On postoperative day 1, thrombin-related hypercoagulability was predominant (15/17 preoperatively, 40/46 postoperatively), whereas platelet-related hypercoagulability was dominant on postoperative day 3 (18/35). Patients who received prophylactic anticoagulation had significantly higher R values on day 3. The ROC curve for D-dimer predicting new-onset VTE showed AUCs of 0.732, 0.790, and 0.847 preoperatively, on days 1, and 3, respectively.Conclusion: D-dimer helps identify high-risk patients for postoperative VTE, while TEG aids in classifying and monitoring hypercoagulability, optimizing anticoagulation therapy choices and dosages.","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"31"},"PeriodicalIF":2.6000,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983890/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thrombosis Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12959-025-00718-8","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Venous thromboembolism (VTE) is a common postoperative complication in oncologic surgery, closely associated with perioperative hypercoagulability. Thromboelastography (TEG) may be an effective method for monitoring hypercoagulability and guiding preventive anticoagulation.

Methods: We prospectively collected perioperative clinical data from lung cancer surgery patients at our hospital between June 2019 and January 2020. TEG and coagulation-related indicators were monitored preoperatively, and on postoperative days 1 and 3. Newly diagnosed postoperative VTE was monitored using lower limb color doppler ultrasound.

Results: A total of 241 lung cancer surgery patients were included, with 25 developing VTE postoperatively (10.4%). TEG results showed a significant decrease in the R value (a thrombin marker) on postoperative day 1, followed by an increase on day 3. The MA value (a platelet marker) increased postoperatively. D-dimer levels also rose after surgery. On postoperative day 1, thrombin-related hypercoagulability was predominant (15/17 preoperatively, 40/46 postoperatively), whereas platelet-related hypercoagulability was dominant on postoperative day 3 (18/35). Patients who received prophylactic anticoagulation had significantly higher R values on day 3. The ROC curve for D-dimer predicting new-onset VTE showed AUCs of 0.732, 0.790, and 0.847 preoperatively, on days 1, and 3, respectively.

Conclusion: D-dimer helps identify high-risk patients for postoperative VTE, while TEG aids in classifying and monitoring hypercoagulability, optimizing anticoagulation therapy choices and dosages.

查看原文本刊更多论文

基于血栓弹性成像的肺癌患者围手术期凝血变化及抗凝疗效动态评价。

背景：静脉血栓栓塞（VTE）是肿瘤外科手术后常见的并发症，与围手术期高凝密切相关。血栓弹性成像（TEG）可能是监测高凝性和指导预防性抗凝的有效方法。方法：前瞻性收集2019年6月至2020年1月我院肺癌手术患者围手术期临床资料。术前、术后第1、3天监测TEG及凝血相关指标。术后新诊断的静脉血栓栓塞采用下肢彩色多普勒超声监测。结果：共纳入241例肺癌手术患者，术后发生静脉血栓栓塞25例（10.4%）。TEG结果显示术后第1天R值（凝血酶标志物）显著降低，第3天R值升高。术后血小板标志物MA值升高。d -二聚体水平在手术后也有所上升。术后第1天，凝血酶相关的高凝性占主导地位（术前15/17，术后40/46），而血小板相关的高凝性在术后第3天占主导地位（18/35）。接受预防性抗凝治疗的患者在第3天的R值显著升高。d -二聚体预测新发VTE的ROC曲线显示，术前第1天、第3天auc分别为0.732、0.790、0.847。结论：d -二聚体有助于识别术后静脉血栓栓塞高危患者，而TEG有助于分类和监测高凝性，优化抗凝治疗方案和剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Thrombosis Journal Medicine-Hematology

CiteScore

3.80

自引率

3.20%

发文量

审稿时长

16 weeks

期刊介绍： Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis. Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.