Risk Factor Evaluation for Venous Thromboembolism during the Perioperative Period in Gynecology and Rationality Analysis of Anticoagulant Drug Use

Xinyi LI; Yong YUAN; Qianmei CHEN; Yan ZHU; Dafang HE; Chunlan ZHANG

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Xinyi LI, Yong YUAN, Qianmei CHEN, Yan ZHU, Dafang HE, Chunlan ZHANG. Risk Factor Evaluation for Venous Thromboembolism during the Perioperative Period in Gynecology and Rationality Analysis of Anticoagulant Drug Use[J]. Journal of Kunming Medical University.

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Risk Factor Evaluation for Venous Thromboembolism during the Perioperative Period in Gynecology and Rationality Analysis of Anticoagulant Drug Use

Department of Pharmacy，Kunming Maternity and Child Health Hospital，Kunming Yunnan 650031，China

Received Date: 2025-05-22
Available Online: 2025-08-13

Abstract

Abstract

Objective To evaluate the high-risk factors for venous thromboembolism （venous thromboembolism, VTE） during the perioperative period in gynecology and analyze the rationality of anticoagulant drug use. Methods Clinical data of 183 gynecological surgical patients treated at Kunming Maternal and Child Health Hospital from January 2023 to December 2024 were collected. Among them, 29 diagnosed with postoperative VTE were classified as the VTE group and 154 diagnosed with no postoperative VTE during the same period were classified as the non-thrombosis group. Independent sample t-test, Mann–Whitney U test, or χ² test were used to analyze high-risk factors for VTE during the perioperative period. Logistic regression analysis was employed to identify risk factors for VTE after the gynecological surgery and a predictive regression model was established. The ROC curve was plotted to evaluate the model’ s validity. Results Elevated D-dimer levels, open abdominal surgery, and history of thrombosis were independent risk factors for VTE in postoperative gynecological patients （OR >1, P < 0.05）. The AUC of the regression-based predictive model was higher than that of the Caprini and G-Caprini scores, indicating that this model had the good discriminatory ability its resolution was better than G-Caprini and Caprini risk assessment tools. The identified issues in VTE prophylaxis at the hospital included the insufficient mechanical prevention time limit and delayed initiation of anticoagulant therapy in patients at moderate risk of bleeding. Conclusion This predictive model has certain clinical value for broader application. For issues related to drug therapy such as delayed use of anticoagulant drugs, clinical pharmacists should collaborate with physicians to assess patients’ bleeding and thrombosis risks, jointly develop precise anticoagulation regimens, and ensure safe and effective pharmacotherapy for patients.
- Perioperative period,
- Thromboembolism,
- Risk assessment,
- Anticoagulant

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References(12)

References

[1]	郎景和,王辰,瞿红,等. 妇科手术后深静脉血栓形成及肺栓塞预防专家共识[J]. 中华妇产科杂志,2017,52(10):649-653. doi: 10.3760/cma.j.issn.0529-567x.2017.10.001
[2]	Insin P,Vitoopinyoparb K,Thadanipon K,et al. Prevention of venous thromboembolism in gynecological cancer patients undergoing major abdominopelvic surgery: A systematic review and network meta-analysis[J]. Gynecol Oncol,2021,161(1):304-313. doi: 10.1016/j.ygyno.2021.01.027
[3]	赵晓鹏,李丹妮,白俊,等. 妇科手术患者静脉血栓栓塞症的危险因素评估和改良评估模型建立[J]. 实用妇产科杂志,2024,40(1):64-68. doi: 10.3969/j.issn.1003-6946.2024.1.syfckzz202401016
[4]	浙江省肺栓塞和深静脉血栓防治联盟. 浙江省医院静脉血栓栓塞症防治管理规范专家共识(第二版)[J]. 加速康复外科杂志,2023,6(3):97-109.
[5]	中国血栓性疾病防治指南专家委员会. 中国血栓性疾病防治指南[J]. 中华医学杂志,2018,98(36):2861-2888
[6]	马军,秦叔逵,吴一龙,等. 肿瘤相关静脉血栓栓塞症预防与治疗指南(2019版)[J]. 中国肿瘤临床,2019,46(13):653-660. doi: 10.3969/j.issn.1000-8179.2019.13.765
[7]	刘凤林,张太平. 中国普通外科围手术期血栓预防与管理指南[J]. 消化肿瘤杂志(电子版),2016,8(2):57-62. doi: 10.3969/j.issn.1674-7402.2016.02.004
[8]	乔宇,武明芬,柳鑫,等. 2021中国静脉血栓栓塞症防治抗凝药物的选用与药学监护指南[J]. 中国临床药理学杂志,2021,37(21):2999-3016.
[9]	陈丽宇,肖娟,吕仙忠,等. 影响孕产妇下肢深静脉血栓预后的危险因素分析[J]. 山东大学学报(医学版),2021,59(7):38-42.
[10]	项汝霏. D-二聚体与FDP联合检测在创伤后深静脉血栓形成风险评估中的应用[J]. 浙江创伤外科,2024,29(11):2162-2164. doi: 10.3969/j.issn.1009-7147.2024.11.052
[11]	方欢,黄劲峰,高伟祺,等. 妇科手术围手术期发生静脉血栓栓塞症的影响因素分析[J]. 中华实用诊断与治疗杂志,2024,38(9):941-946.
[12]	Alba A C,Agoritsas T,Walsh M,et al. Discrimination and Calibration of clinical prediction models: Users' guides to the medical literature[J]. JAMA,2017,318(14):1377-1384. doi: 10.1001/jama.2017.12126

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