Background: The fear of an early post-pancreatectomy haemorrhage (PPH) may prevent surgeons from prescribing post-operative venous thromboembolism (VTE) chemoprophylaxis. The primary hypothesis of this study was that the national post-pancreatectomy early PPH rate was lower than the rate of VTE. The secondary hypothesis was that patients at high risk for post-discharge VTE could be identified, potentially facilitating the selective use of extended chemoprophylaxis.
Patients And Methods: All elective pancreatectomies were identified in the 2005 to 2010 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database. Factors associated with 30-day rates of (pre- versus post-discharge) VTE, early PPH (transfusions > 4 units within 72 h) and return to the operating room (ROR) with PPH were analysed.
Results: Pancreaticoduodenectomies (PD) and distal pancreatectomies (DP) numbered 9140 (66.4%) and 4631 (33.6%) out of 13 771 pancreatectomies, respectively. Event rates included: VTE (3.1%), PPH (1.1%) and ROR+PPH (0.7%). PD and DP had similar VTE rates (P > 0.05) with 31.9% of VTE occurring post-discharge. Independent risk factors for late VTE included obesity [odds ratio (OR), 1.5], age ≥ 75 years (OR, 1.8), DP (OR, 2.4) and organ space infection (OR, 2.1) (all P < 0.02).
Conclusions: Within current practice patterns, post-pancreatectomy VTE outnumber early haemorrhagic complications, which are rare. The fear of PPH should not prevent routine and timely post-pancreatectomy VTE chemoprophylaxis. Because one-third of VTE occur post-discharge, high-risk patients may benefit from post-discharge chemoprophylaxis.
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http://dx.doi.org/10.1111/hpb.12148 | DOI Listing |
Lancet Reg Health Am
February 2025
University of Vermont Cancer Center, 89 Beaumont Ave, Burlington, VT, 05405, USA.
Thromb J
January 2025
Department of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai, 200040, China.
Background: Venous thromboembolism (VTE) is a common vascular disease with a significant global burden, influenced by multiple factors, such as genetic, environmental, and immune components. Immune responses and shifts in immune cell profiles are closely linked to the development and progression of VTE, yet current studies are limited by confounding factors and reverse causation. To address these limitations, this study uses Mendelian randomization to explore the causal relationship between immune cell traits and VTE, aiming to provide insights into underlying mechanisms.
View Article and Find Full Text PDFJ Phys Chem Lett
January 2025
School of Physics, Nankai University, Tianjin 300071, China.
CdZnTe (CZT) has garnered substantial attention due to its outstanding performance in room-temperature semiconductor radiation detectors, where carrier transport properties are critical for assessing the detector performance. However, due to the complexities of crystal growth, CZT is prone to defects that affect carrier lifetime and mobility. To investigate how defects affect nonequilibrium carrier transport, nonadiabatic molecular dynamics (NAMD) is employed to examine six types of intrinsic defects and their impact on electron-hole (e-h) recombination.
View Article and Find Full Text PDFJ Thromb Haemost
January 2025
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Office of the Vice-Principal of Research and Innovation, University of Toronto Mississauga, Mississauga, Canada. Electronic address:
Background: Whether to stop oral anticoagulants after a first unprovoked venous thromboembolism (VTE) is challenging, partially due to an intriguingly higher risk of VTE recurrence (rVTE) in men after therapy discontinuation. DNA methylation (DNAm) differences between men and women might underly this sex-biased rVTE risk difference.
Aim: To investigate sex-specific associations between DNAm at cytosine-phosphate-guanine (CpG) sites and rVTE.
United European Gastroenterol J
January 2025
Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy.
Background & Aims: Venous thromboembolism (VTE) is a recognized complication of acutely ill patients, but its incidence and risk factors in those with cirrhosis are uncertain.
Methods: We retrospectively studied a consecutive cohort of cirrhosis patients non-electively admitted to our medical unit to determine the rates of symptomatic VTE during hospitalization. Firstly, we explored associations with baseline, clinical and laboratory characteristics using logistic regression.
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