Chen Jing, Mao Yuanzheng, Peng Zhiyu
Department of Emergency Medicine, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, 610041, China.
Disaster Medical Center, Sichuan University, Chengdu, 610041, China.
J Thromb Thrombolysis. 2025 Aug 8. doi: 10.1007/s11239-025-03164-5.
Venous thromboembolism (VTE) remains a major contributor to postoperative morbidity and mortality in patients undergoing lung cancer surgery. This study aims to identify perioperative risk factors associated with VTE development following such procedures. We performed an exhaustive search of PUBMED and EMBASE from inception to November 1, 2023, using terms related to VTE following lung cancer surgery. A random-effects meta-analysis was performed to calculate the pooled incidence and odds ratios (ORs) for risk factors. Of 3,576 screened studies, 13 met eligibility criteria for qualitative synthesis, and 11 studies (53,382 patients) were included in the meta-analysis. The pooled incidence of postoperative VTE was 1.82% (971 cases). Significant risk factors included advanced age (standardized mean difference [SMD] 0.43, 95% CI 0.22-0.63; I = 59.9%), prolonged surgical duration (SMD 0.58, 95% CI 0.24-0.92; I = 81.2%), open thoracotomy (OR 1.77, 95% CI 1.50-2.09; I = 19.9%), TNM stage > 1 (OR = 1.81, 95% CI 1.53-2.13; I = 39.8%), adenocarcinoma histology (OR = 1.29, 95% CI 1.08-1.53; I = 1.2%), and major lung resection (OR = 1.51, 95% CI 1.24-1.83; I2 = 0.0%). This study highlights key modifiable and non-modifiable risk factors for postoperative VTE in lung cancer surgery patients. These findings support individualized risk stratification and targeted thromboprophylaxis strategies to improve clinical outcomes.
静脉血栓栓塞症（VTE）仍然是肺癌手术患者术后发病和死亡的主要原因。本研究旨在确定此类手术后与VTE发生相关的围手术期风险因素。我们使用与肺癌手术后VTE相关的术语，对PUBMED和EMBASE从创刊到2023年11月1日进行了详尽搜索。进行随机效应荟萃分析以计算风险因素的合并发病率和比值比（OR）。在3576项筛选研究中，13项符合定性综合的纳入标准，11项研究（53382例患者）纳入荟萃分析。术后VTE的合并发病率为1.82%（971例）。显著的风险因素包括高龄（标准化均数差[SMD]0.43，95%CI 0.22 - 0.63；I² = 59.9%）、手术时间延长（SMD 0.58，95%CI 0.24 - 0.92；I² = 81.2%）、开胸手术（OR 1.77，95%CI 1.50 - 2.09；I² = 19.9%）、TNM分期>1（OR = 1.81，95%CI 1.53 - 2.13；I² = 39.8%）、腺癌组织学类型（OR = 1.29，95%CI 1.08 - 1.53；I² = 1.2%）和肺叶切除术（OR = 1.51，95%CI 1.24 - 1.83；I² = 0.0%）。本研究强调了肺癌手术患者术后VTE的关键可改变和不可改变风险因素。这些发现支持个体化风险分层和针对性血栓预防策略，以改善临床结局。
