Postoperative symptomatic venous thrombosis following thoracic surgery in high-altitude dwellers

Background

High altitude and environmental changes were considered as high-risk factors leading to venous thrombosis events (VTEs). It's unclear whether the high-altitude could influence the postoperative VTE incidence.

Methods

Patients' data between January 2014 and December 2022 was collected in department of thoracic surgery of People's Hospital of Ganzi Tibetan autonomous prefecture, which serving the population at geographic southeastern Tibetan Plateau. Postoperative thromboprophylaxis included early out-of-bed activity and intermittent pneumatic compression (IPC) device of lower limbs. Prophylactic anticoagulant drug wasn't used conventionally. Symptomatic VTE was diagnosed by symptom recognition and vascular ultrasonography confirmation of lower limbs. Chest computerized tomography angiography was subsequently performed to verify pulmonary embolism or not.

Results

Total 204 patients have undergone thoracic surgery. Mean age was 42.6 ± 16.9 years. Mean resident altitude of the patients was 3663.7 ± 538.7 m. 37 patients (18.1 %) had erythremia, 33 patients (16.2 %) had hyperhemoglobinemia, and 76 patients (37.3 %) had thrombocythemia. Six patients (2.94 %) had postoperative symptomatic VTE, and no pulmonary embolism was found. The age and malignant disease found significantly higher (58.0 vs. 42.1 years, 50.0 % vs.13.6 % respectively) in VTE patient group. Logistical regression showed no significant risk factor of postoperative VTE of high-altitude dwellers.

Conclusions

The high-altitude dwellers didn't seem to have much high symptomatic VTE tendency after thoracic surgery. The high altitude and subsequent changes were not independent factors of postoperative VTE. The postoperative thromboprophylaxis (early out-of-bed activity, IPC, and no prophylactic anticoagulant drug use) were effective preventing postoperative symptomatic VTE for high-altitude dwellers.