Comparison and Risk factors of early and late pulmonary embolism in patients after major cancer surgery

Abstract

Abstract Background Postoperative pulmonary embolism (PE) is a severe complication in patients underwent major cancer surgery. We assume the pathogeny of early and late PE are different, and design a retrospective study to examine the potential predisposing factors for early and late postoperative PE. MethodsWe investigated patients underwent major cancer surgery in Sichuan Cancer Hospital from April 2016 to May 2022. Postoperative PE was divided into early and late phase by three days after operation. Early PE patients and late PE patients were compared to non-PE postoperative patients in a 1-2 ratio, matched for age (± 3 years), type of cancer and cancer site. Logistic regression analysis and least absolute shrinkage and selection operator (LASSO) regression analysis were used to identify risk factors of early PE and late PE respectively. Results There were thirty-six patients were collected as early PE group, and 46 patients were allocated to late PE. There were no significant differences in demographics, cancer type, cancer stage, PE location and mortality between early PE group and late PE group. After LASSO logistic regression, early postoperative PE was significantly associated with Body mass index (BMI), intraoperative hypotension time (IHT) and postoperative D-dimer value (P<0.05). Postoperative D-dimer value and severe infection were the independent risk factors for late PE (P<0.05). Conclusions BMI, IHT are the risk factors for early PE and severe infection is the risk factor for late PE. In addition, a high postoperative D-dimer level has a strong relationship with both early PE and late PE.