Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Lower early mortality and risk prediction improvement of obesity after acute pulmonary embolism: results from a multicenter cohort analysis with external validation","authors":"Romain Chopard ,&nbsp;Laurent Bertoletti ,&nbsp;Marc Badoz ,&nbsp;Nicolas Meneveau ,&nbsp;Fiona Ecarnot ,&nbsp;Luciano López Jiménez ,&nbsp;Olga Madridano ,&nbsp;José Antonio Díaz Peromingo ,&nbsp;Meritxell López De la Fuente ,&nbsp;Manuel Monreal ,&nbsp;Gregory Piazza ,&nbsp;RIETE Investigators","doi":"10.1016/j.rpth.2025.102718","DOIUrl":"10.1016/j.rpth.2025.102718","url":null,"abstract":"<div><h3>Background</h3><div>The relationship between obesity (defined as body mass index [BMI] ≥ 30 kg/m²) and mortality in venous thromboembolism remains controversial.</div></div><div><h3>Objectives</h3><div>We aimed to compare outcomes after pulmonary embolism (PE) between patients with obesity and nonobese, nonunderweight patients.</div></div><div><h3>Methods</h3><div>Using a multicenter registry of prospectively recorded individual patient data, we compared outcome rates using multivariable logistic or Cox regression for 30-day and 6-month outcomes respectively (etiologic analysis). We assessed the incremental value of adding BMI information on top of the 30-day European Society of Cardiology (ESC) prognostic algorithm (prognostic analysis).</div></div><div><h3>Results</h3><div>We included 2390 patients with BMI of ≥18.5 kg/m² (mean age, 66.9 ± 16.8 years; 1188 men [49.7%]); 686 patients [28.7%] were in the obese group. Mortality rates were significantly lower in patients with obesity than that in patients who were nonobese at 30 days (3.2% [95% CI, 2.0-4.8] vs 5.9% [95% CI, 4.8-7.1]), and 6 months (8.1% [95% CI, 6.2-10.4] vs 16.3% [95% CI, 14.6-18.1]). Rates of secondary nonfatal outcomes (including bleeding, recurrent venous thromboembolism, myocardial infarction, and stroke) did not differ between groups. The addition of the obesity information on top of the ESC prognostic model improved global model fit and discriminatory (Harrell C index from 0.636 to 0.657; <em>P</em> = .07) and calibration capacities (<em>P</em> (Hosmer–Lemeshow) = .02 vs .13), yielding significant reclassification (ie, 10.3%) based on the observed mortality rates with the ESC model as reference. Findings were confirmed in an external validation using 35,796 patients with PE from the RIETE registry.</div></div><div><h3>Conclusion</h3><div>We present evidence indicating lower early- and mid-term mortality after PE in patients classified as obese based on BMI, compared with nonobese, nonunderweight patients. BMI should likely be incorporated into algorithms or scoring systems for predicting early mortality following PE.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102718"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world bleeding rates on emicizumab: the value of using nationwide digital treatment diary data in clinical research","authors":"Martijn R. Brands ,&nbsp;Elisabeth M. Taal ,&nbsp;Martijn Oude Voshaar ,&nbsp;Mariëtte H.E. Driessens ,&nbsp;Caroline M.E. van Veen ,&nbsp;Marieke J.H.A. Kruip ,&nbsp;Paul L. den Exter ,&nbsp;Britta A.P. Laros-van Gorkom ,&nbsp;Marjet A. Stein-Wit ,&nbsp;Kathelijn Fischer ,&nbsp;Stephan Meijer ,&nbsp;Karina Meijer ,&nbsp;Marlène Beijlevelt ,&nbsp;Karin Fijnvandraat ,&nbsp;Samantha C. Gouw","doi":"10.1016/j.rpth.2025.102717","DOIUrl":"10.1016/j.rpth.2025.102717","url":null,"abstract":"<div><h3>Background</h3><div>People with hemophilia in the Netherlands log bleeds and infusions through a digital treatment diary. With the current innovations in hemophilia treatments, the use of patient-reported bleeding data will become increasingly important.</div></div><div><h3>Objective</h3><div>To assess real-world bleeding rates on emicizumab in a nationwide cohort of people with severe hemophilia A, and assess the value of digital treatment diary data.</div></div><div><h3>Methods</h3><div>People with severe hemophilia A of all ages with and without inhibitors using emicizumab who use the digital treatment diary were included. From 2018 to October 2023, data on bleeds treated with clotting factor concentrate were collected from digital treatment diaries and electronic health records. Mean (95% CI) annualized (joint) bleeding rates were calculated using negative-binomial regression analyses. Proportions of people with zero-treated (joint) bleeds were assessed using Kaplan–Meier survival analysis. We calculated the proportion of all bleeds that were recorded in digital treatment diaries.</div></div><div><h3>Results</h3><div>The 232 included persons (median age, 27 years; IQR, 13-51) who used emicizumab for a median of 27 months (IQR, 14-31 months). The mean treated annualized bleeding rate and annualized joint bleeding rate were 1.5 (CI, 1.3-1.8) and 0.8 (CI, 0.6-1.0), respectively. At 24 weeks, 63% had zero-treated bleeds, and 80% had zero-treated joint bleeds. Of treated bleeds, 67% (310/460) were reported in digital treatment diaries.</div></div><div><h3>Conclusion</h3><div>Bleeding rates among Dutch people with severe hemophilia A using emicizumab were comparable to other real-world studies. We formulated recommendations to improve the quality of patient-reported bleeding data, such as establishing guidelines for recording bleeds and improving interoperability.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102717"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of factor X deficiency induced by valproic acid","authors":"Pierre-Antonin Rigon ,&nbsp;Vincent Ernest","doi":"10.1016/j.rpth.2025.102721","DOIUrl":"10.1016/j.rpth.2025.102721","url":null,"abstract":"<div><h3>Background</h3><div>Factor X (FX) deficiency (FXD) significantly disrupts coagulation, potentially leading to severe bleeding. While inherited FXD is rare, with a prevalence of 1 in 500,000, acquired FXD is also uncommon and frequently linked to conditions such as light-chain amyloidosis. In rare cases, certain medications can cause FXD.</div></div><div><h3>Key Clinical Question</h3><div>Here, we present a rare case of acquired FXD induced by valproic acid (VPA). This deficiency is associated with the presence of anti-FX antibodies.</div></div><div><h3>Clinical Approach</h3><div>A 65-year-old man undergoing treatment for various conditions, including chronic kidney disease and type 2 diabetes, developed severe FXD (activity &lt;2 U/L) following VPA administration for epilepsy. During FXD, the patient experienced significant bleeding episodes, necessitating FX replacement with prothrombin complex concentrate. Upon discontinuation of VPA, FX activity improved in 9 days, possibly suggesting a role of the drug in FXD. Interestingly, antibodies directed against FX have been identified.</div></div><div><h3>Conclusion</h3><div>This case emphasizes the necessity for clinicians to be vigilant of hemostasis disorders associated with VPA, even though such occurrences are rare.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102721"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexuality and bleeding in von Willebrand disease","authors":"Calvin B. van Kwawegen ,&nbsp;Hester Pastoor ,&nbsp;Jeroen Eikenboom ,&nbsp;Karin Fijnvandraat ,&nbsp;Paula Ypma ,&nbsp;Floor C.J.I. Heubel-Moenen ,&nbsp;Karin P.M. van Galen ,&nbsp;Evelien P. Mauser-Bunschoten ,&nbsp;Karina Meijer ,&nbsp;Saskia E.M. Schols ,&nbsp;Marjon H. Cnossen ,&nbsp;Johanna G. van der Bom ,&nbsp;Joke de Meris ,&nbsp;Ferdows Atiq ,&nbsp;Marieke J.H.A. Kruip ,&nbsp;Frank W.G. Leebeek","doi":"10.1016/j.rpth.2025.102712","DOIUrl":"10.1016/j.rpth.2025.102712","url":null,"abstract":"<div><h3>Background</h3><div>Sexuality is a fundamental aspect of quality of life, often impacted by chronic or inherited diseases like von Willebrand disease (VWD), an inherited bleeding disorder characterized by mucosal bleeding, including heavy menstrual bleeding (HMB). To date, no studies have investigated the impact of VWD on sexuality.</div></div><div><h3>Objectives</h3><div>This study aimed to identify sexual restrictions and symptoms in VWD patients, differentiating between men and women and between premenopausal and nonmenstruating women.</div></div><div><h3>Methods</h3><div>We performed a nationwide, multicenter, prospective cohort study, the Willebrand in the Netherlands-Prospective study, including adult VWD patients (&gt;18 years) who completed questionnaires on sexuality and health-related quality of life (SF-36). Additional data were collected via blood tests and a self-reported bleeding assessment tool (International Society on Thrombosis and Haemostasis Bleeding Assessment Tool).</div></div><div><h3>Results</h3><div>We included 549 VWD patients with a median age of 51 years (IQR, 37-66 years), of whom the majority were women (<em>n</em> = 347; 63.2%). Patients were diagnosed with type 1 (57.2%), type 2 (39.2%), or type 3 VWD (3.6%). Sexual restrictions due to VWD were reported by 3.5% of men (<em>n</em> = 7) and 9.8% of women (<em>n</em> = 34; <em>P</em> &lt; .01). Bleeding during sexual activity was reported by 33.1% (<em>n</em> = 115) of women. Premenopausal patients more often reported sexual restrictions than nonmenstruating patients (15.5% vs 5.2%, <em>P</em> = .01), with HMB as the most important determinant (odds ratio, 1.60; 95% CI, 1.12-2.46). Most patients (<em>n</em> = 455; 82.9%) reported that sexuality was not discussed during routine clinic visits.</div></div><div><h3>Conclusion</h3><div>Women with VWD experience more sexual restrictions than men and report more postcoital bleeding than the general population. Premenopausal women are particularly affected, mostly due to HMB. This highlights the need for health care providers to address sexual health during consultations and treat HMB to improve overall care for VWD patients.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102712"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major bleeding and thromboembolic complications associated with antithrombotic treatment in patients with atrial fibrillation/flutter and incident cancer","authors":"Gordon Chu ,&nbsp;Nienke van Rein ,&nbsp;Menno V Huisman ,&nbsp;Lars Pedersen ,&nbsp;Henrik T. Sørensen ,&nbsp;Suzanne C. Cannegieter ,&nbsp;Frederikus A. Klok","doi":"10.1016/j.rpth.2025.102697","DOIUrl":"10.1016/j.rpth.2025.102697","url":null,"abstract":"<div><h3>Background</h3><div>Anticoagulant management of patients with atrial fibrillation with active cancer is complex because cancer increases the risk of thrombosis as well as bleeding. Previous studies have investigated the impact of any type of cancer, while outcomes may differ per specific type. We performed the present study to provide more insight into the impact of specific types of cancer on clinical outcomes.</div></div><div><h3>Objectives</h3><div>We examined major bleeding (MB) and thromboembolism (TE) rates associated with antithrombotic treatment in patients with atrial fibrillation/flutter (AF) who develop cancer and examined whether cancer type affected MB and TE risks.</div></div><div><h3>Methods</h3><div>This Danish population-based cohort study included all patients aged ≥ 50 years discharged with incident AF between January 1, 1995, and December 31, 2016, and identified those who subsequently developed cancer. Data on cancer type, outcomes, and antithrombotic exposure were obtained from hospital and drug prescription databases. Follow-up continued from the time of cancer diagnosis until the occurrence of an outcome or the end of the 2-year follow-up. Incidence rates (IRs) per 100 patient-years and adjusted hazard ratios with corresponding 95% CIs were calculated using Cox regression.</div></div><div><h3>Results</h3><div>A total of 22,996 patients with AF with subsequent incident cancer were identified. These patients had higher MB (IR, 5.36 [95% CI, 5.09-5.64] vs 2.27 [95% CI, 2.22-2.32]) and TE (IR, 3.91 [95% CI, 3.68-4.15] vs 2.71 [95% CI, 2.66-2.76]) rates than those without cancer. The higher MB rate was observed across all antithrombotic exposure categories. Urogenital (IR, 6.43 [95% CI, 5.94-6.95]) and intracranial cancer (IR, 6.36 [95% CI, 3.85-9.76]) demonstrated the highest MB rates; hematologic (IR, 4.92 [95% CI, 4.12-5.82]) and gastrointestinal cancer (IR, 4.82 [95% CI, 4.31-5.36]) had the highest TE rates. A particularly high MB rate was observed in patients with AF with gastrointestinal cancer and triple antithrombotic therapy (IR, 39.0 [95% CI, 15.5-79.1]).</div></div><div><h3>Conclusion</h3><div>Patients with AF with certain incident cancer types experienced higher rates of MB and TE than those without cancer. Dual/triple antithrombotic therapy in patients with AF with incident cancer was associated with high bleeding rates, particularly with gastrointestinal cancer.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102697"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thrombotic microangiopathic anemia in patients with sickle cell disease and its variants during a vaso-occlusive crisis","authors":"Wouhabe Bancheno ,&nbsp;Donna Alexander ,&nbsp;Mekdem Melaku ,&nbsp;Bary Malik","doi":"10.1016/j.rpth.2025.102734","DOIUrl":"10.1016/j.rpth.2025.102734","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102734"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illustrated capsules from the Advanced Course in Platelet Research","authors":"Christian Andrea Di Buduo ,&nbsp;Vittorio Abbonante ,&nbsp;Alessandro Malara ,&nbsp;Alessandra Balduini ,&nbsp;Amie K. Waller ,&nbsp;Steve P. Watson ,&nbsp;Eleyna M. Martin ,&nbsp;Lloyd Bridge ,&nbsp;Jonathan Gibbins ,&nbsp;Ingeborg Hers ,&nbsp;Claire Masson ,&nbsp;Anita Eckly ,&nbsp;Natalie S. Poulter ,&nbsp;Beatriz Martínez-García ,&nbsp;Sonia Aguila ,&nbsp;Paolo Gresele ,&nbsp;Stefania Momi ,&nbsp;Paul Amstrong ,&nbsp;Matthew Rondina ,&nbsp;Sara Troitiño ,&nbsp;Chris Ward","doi":"10.1016/j.rpth.2025.102715","DOIUrl":"10.1016/j.rpth.2025.102715","url":null,"abstract":"<div><div>This series of illustrated capsules summarizes the presentations made by the speakers at the first International Advanced Course in Platelet Research held in Murcia (Spain) from 27 to 28 September, 2024. This is the first course to receive a Fundamental Research Workshop Grant from the International Society on Thrombosis and Haemostasis (ISTH) and was also supported administratively and scientifically by the Spanish Society of Thrombosis and Haemostasis (SETH). This unique course focused on new methodologies applied in platelet research and how these are increasing our understanding of platelet formation, their multifunctionality in different physiological and pathological contexts, and contributing to the development of new platelet-targeted therapies to improve the management of hemostatic/thrombotic pathologies. It aligns with the objectives of several Scientific and Standardization Committees of the ISTH, including Platelet Physiology and Genomics in Thrombosis and Haemostasis, as well as with the academic objectives of the ISTH and SETH. The program was designed by the coordinator (J. Rivera), and the scientific advisory board (SAB: S.P. Watson, K. Freson, A. Balduini, and J. Di Paola) and comprised 9 scientific sessions with 25 presentations, each with time for extensive open discussion. Additionally, 33 abstract posters were presented, with the 3 highest scoring selected as oral presentations. The course was held in a single location and with an informal atmosphere to facilitate networking among participants. The course received very positive feedback from the 140 attendees. The course was supported by the ISTH, SETH, University of Murcia, CIBERER-ISCIII, Fundación Séneca (22426/OC/24), the United Kingdom Platelet Society and various pharmaceutical companies. We believe that the extraordinary scientific and human experience of this course may act as a stimulus for future courses.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102715"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 7 artificial intelligence models in predicting venous thromboembolism in COVID-19 patients","authors":"Indika Rajakaruna ,&nbsp;Mohammad Hossein Amirhosseini ,&nbsp;Mike Makris ,&nbsp;Mike Laffan ,&nbsp;Yang Li ,&nbsp;Deepa J. Arachchillage","doi":"10.1016/j.rpth.2025.102711","DOIUrl":"10.1016/j.rpth.2025.102711","url":null,"abstract":"<div><h3>Background</h3><div>An artificial intelligence (AI) approach can be used to predict venous thromboembolism (VTE).</div></div><div><h3>Objectives</h3><div>To compare different AI models in predicting VTE using data from patients with COVID-19.</div></div><div><h3>Methods</h3><div>We used feature ranking through recursive feature elimination with AI algorithms (logistic regression and random forest classifier) and standard statistical methods to identify the significant factors that contribute to developing VTE in COVID-19 patients using a large dataset from “Coagulopathy associated with COVID-19,” a multicenter observational study. We developed 7 AI models (Multilayer perceptron classifier, Artificial neural network with backpropagation, eXtreme gradient boosting, Support vector classifier, Stochastic gradient descent classifier, Random forest classifier and Logistic regression classifier) using the selected significant features to predict the development of VTE during hospitalization and used K-fold cross-validation and hyperparameter tuning to validate and optimize the models. The models’ predictive power was tested on 2649 (33% of 8027 overall patients), which were previously separated and not used during model training and validation stages.</div></div><div><h3>Results</h3><div>Age, female sex, white ethnicity, comorbidities (diabetes, liver disease, autoimmune disease), and laboratory features (increased hemoglobin, white cell count, D-dimer, lactate dehydrogenase, ferritin), and presence of multiorgan failure were major factors associated with the development of thrombosis. Support vector classifier (SVC) model outperformed all other models, achieving an accuracy of 97%. The SVC model also led in precision (0.98), recall (0.97), and F1 score (0.97), and recorded the lowest log-loss score (0.112 on the test dataset), reflecting better model convergence and an improved fit to the data. Additionally, it achieved the highest area under the curve score (0.983).</div></div><div><h3>Conclusion</h3><div>The SVC model delivered the best overall performance outperforming similar studies that developed deep learning and machine-learning models for COVID-19.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102711"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ex vivo lentiviral gene therapy for severe hemophilia A: an alternative to recombinant adeno-associated viral-based strategies?","authors":"Benjamin J. Samelson-Jones","doi":"10.1016/j.rpth.2025.102716","DOIUrl":"10.1016/j.rpth.2025.102716","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102716"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High preoperative D-dimer increases the risk of venous thromboembolism after gynecological tumor surgeries: a meta-analysis of cohort studies","authors":"Zeyu Meng ,&nbsp;Lu Liu ,&nbsp;Xu Yang ,&nbsp;Xingxu Hu ,&nbsp;Yaping Xi ,&nbsp;Qinglin Yang ,&nbsp;Yun Luo ,&nbsp;Donghong Wang ,&nbsp;Jun Liu","doi":"10.1016/j.rpth.2025.102690","DOIUrl":"10.1016/j.rpth.2025.102690","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 2","pages":"Article 102690"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}