The Incidence and Characteristics of Venous Thromboembolism in Neurocritical Care Patients: A Prospective Observational Study

Risk of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is presumed to be high for neurologic intensive care unit (NICU) patients. However, exact incidences of VTE have yet to be reported. In this prospective observational study, we consecutively enrolled 126 neurocritical care patients who had an NICU stay ≥1 week with paralysis and/or unconsciousness. All patients received DVT prevention strategies. Patients were screened for VTE after 1 week of hospitalization, using venous ultrasonography and computed tomography pulmonary angiography. Following 1 week of NICU hospitalization, DVT incidence was 35.7% and PE incidence was 17.5%. Of the DVTs, 75.6% were in the muscular calf vein. Of the PEs, 22.7% were in main pulmonary arteries, while 77.3% were in branches. Approximately 96% of the DVTs and 86% of the PEs were asymptomatic. Approximately 24% of patients with DVT had a concurrent PE, while 50% of PE patients had a DVT. Paralysis, raised d-dimer on admission, and pulmonary infection were found to be independent risk factors for DVT. Paraplegia, femoral vein thrombosis, and pulmonary infection were found to be independent risk factors for PE. Despite active preventive measures, incidences of VTE in NICU patients were high. Most VTEs were asymptomatic, meaning they could have led to a missed diagnosis. Attention should be paid to the VTE events of critically ill neurological patients.

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Venous thromboembolism in the critically ill: A prospective observational study of occurrence, risk factors and outcome

Acta Anaesthesiologica Scandinavica ◽

10.1111/aas.13316 ◽

2019 ◽

Vol 63 (5) ◽

pp. 630-638 ◽

Cited By ~ 7

Author(s):

Sigrid Beitland ◽

Henning Wimmer ◽

Torleif Lorentsen ◽

Dag Jacobsen ◽

Tomas Drægni ◽

...

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Observational Study ◽

Critically Ill ◽

Prospective Observational Study

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Evaluation of UGT1A1 genotyping for predicting individual toxicity of irinotecan plus platinum analog regimens: Interim safety analysis of a prospective observational study.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.11049 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 11049-11049

Author(s):

Masashi Takano ◽

Kaichiro Yamamoto ◽

Tsutomu Tabata ◽

Yuji Minegishi ◽

Takuma Yokoyama ◽

...

Keyword(s):

Risk Factors ◽

Observational Study ◽

Prospective Observational Study ◽

Daily Practice ◽

Hematological Toxicity ◽

Logistic Regression Models ◽

Potential Biomarker ◽

Independent Risk Factors ◽

Grade 3 ◽

Clinical Trial Information

11049 Background: Irinotecan (IRI)+platinum (Pt) therapy works synergistically and is widely used for solid carcinomas. Although UGT1A1 genotyping has been implemented in daily practice since long, recommended doses of IRI+Pt therapy according to UGT1A1 genotyping remain undetermined. Risk factors for severe toxicities of IRI+Pt regimens remain uncertain. We conducted a prospective observational study to examine the correlation between UGT1A1 genotyping and toxicity/efficacy in IRI+Pt regimens (NCT 01040312). Methods: During October 2009 and March 2012, 321 patients were enrolled. Eligible patients had histologically confirmed SCLC, non-SCLC, cervical, ovarian, or gastric cancer; had PS 0-2; and were receiving IRI+Pt (cisplatin, carboplatin, and nedaplatin) regimen, following UGT1A1 genotyping: hetero (*1/*6, *1/*28) and homo (*6/*6, *6/*28, *28/*28). Primary endpoint was to evaluate overall toxicity profile during first 3 cycles of treatment. In this interim analysis, incidences of grade 3/4 toxicities were compared among UGT1A1 phenotypes, and logistic regression models were used to identify independent risk factors for these toxicities. Results: At the time of abstract writing, toxicity data from 137 patients were available. There were 110 (80%) hetero and 27 (20%) homo genotypes. Combination therapy of IRI (57.2 ± 12.2 mg/m2 for average initial dose) and Pt analogs (cisplatin, 63%; carboplatin, 20%; nedaplatin, 17%) was administered. Incidences of grade 3/4 toxicities during first 3 cycles of treatment in hetero and homo were as follows: leukocytopenia, 38% and 59%; neutropenia, 55% and 67%; thrombocytopenia, 7% and 22%; and diarrhea, 9% and 7%. Overall grade 3/4 hematological toxicity was 50% (55/110) in hetero and 78% (21/27) in homo; the adjusted odds ratio was 3.379 (p = 0.0185) in homo compared with hetero. Conclusions: A higher rate of grade 3/4 hematological toxicity in homo than in hetero was confirmed with IRI+Pt therapy. Thus, UGT1A1 genotyping could be a potential biomarker of toxicity with individualized chemotherapy using low-dose IRI regimens. At the presentation, analysis of >250 patients’ data will be shown. Clinical trial information: NCT01040312.

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Prevention, treatment, and risk factors of deep vein thrombosis in critically ill patients in Zhejiang province, China: a multicenter, prospective, observational study

Annals of Medicine ◽

10.1080/07853890.2021.2005822 ◽

2021 ◽

Vol 53 (1) ◽

pp. 2234-2245

Author(s):

Li Li ◽

Jia Zhou ◽

Liquan Huang ◽

Junhai Zhen ◽

Lina Yao ◽

...

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Prospective Observational Study ◽

Zhejiang Province ◽

Vein Thrombosis ◽

Multicenter Prospective Observational Study ◽

Deep Vein

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Risk factors for chemotherapy-associated venous thromboembolism in a prospective observational study

Cancer ◽

10.1002/cncr.21496 ◽

2005 ◽

Vol 104 (12) ◽

pp. 2822-2829 ◽

Cited By ~ 343

Author(s):

Alok A. Khorana ◽

Charles W. Francis ◽

Eva Culakova ◽

Gary H. Lyman

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Observational Study ◽

Prospective Observational Study

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Independent risk factors for adverse events associated with propofol-based pediatric sedation performed by anesthesiologists in the radiology suite: a prospective observational study

European Journal of Pediatrics ◽

10.1007/s00431-020-03916-w ◽

2021 ◽

Author(s):

Jeong-Rim Lee ◽

Jae Hoon Lee ◽

Hye-Mi Lee ◽

Nayeon Kim ◽

Myoung Hwa Kim

Keyword(s):

Risk Factors ◽

Adverse Events ◽

Observational Study ◽

Prospective Observational Study ◽

Radiology Suite ◽

Independent Risk Factors ◽

Pediatric Sedation

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Wound infection in colorectal cancer resections through a laparoscopic approach: a single-center prospective observational study of over 3000 cases

Discover Oncology ◽

10.1007/s12672-021-00396-8 ◽

2021 ◽

Vol 12 (1) ◽

Cited By ~ 1

Author(s):

Atsushi Ikeda ◽

Yosuke Fukunaga ◽

Takashi Akiyoshi ◽

Satoshi Nagayama ◽

Toshiya Nagasaki ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factors ◽

Laparoscopic Surgery ◽

Observational Study ◽

Wound Infection ◽

Prospective Observational Study ◽

Rectal Surgery ◽

Colonic Surgery ◽

Laparoscopic Rectal Surgery ◽

Independent Risk Factors

Abstract Objectives This prospective observational study aimed to clarify the incidence and independent risk factors of wound infection after laparoscopic surgery for primary colonic and rectal cancer. Methods A prospective surveillance of surgical site infection (SSI) was conducted in consecutive patients with primary colorectal cancer, who underwent elective laparoscopic surgery in a single comprehensive cancer center between 2005 and 2014. The outcomes of interest were the incidence and risk factors of wound infection. Results In total, 3170 patients were enrolled in the study. The overall incidence of wound infection was 3.0%. The incidence of wound infection was significantly higher in rectal surgery than in colonic surgery (4.7 vs. 2.1%, p < 0.001). In rectal surgery, independent risk factors for developing wound infection included abdominoperineal resection (p < 0.001, odds ratio [OR] = 11.4, 95% confidence interval [CI]: 5.04–24.8), body mass index (BMI) ≥ 25 kg/m2 (p = 0.041, OR = 1.97, 95% CI, 1.03–3.76), and chemoradiotherapy (p = 0.032, OR = 2.18, 95% CI, 1.07–4.45). In laparoscopic colonic surgery, no significant risk factors were identified. Conclusions Laparoscopic rectal surgery has a higher risk of wound infection than colonic surgery. Laparoscopic rectal surgery involving abdominoperineal resection, patients with higher BMI, and chemoradiotherapy requires careful observation in wound care and countermeasures against wound infection.

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PS02.216: PROPHYLAXIS OF POSTOPERATIVE VENOUS THROMBOEMBOLISM USING ENOXAPARIN AFTER ESOPHAGECTOMY: A PROSPECTIVE OBSERVATIONAL STUDY FOR EFFECTIVENESS AND SAFETY

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.216 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 183-183

Author(s):

Naoya Yoshida ◽

Yoshifumi Baba ◽

Yohei Nagai ◽

Kazuo Okadome ◽

Yuki Kiyozumi ◽

...

Keyword(s):

Venous Thromboembolism ◽

Adverse Events ◽

Observational Study ◽

Prospective Observational Study ◽

Postoperative Morbidity ◽

Conflicts Of Interest ◽

Coagulation System ◽

Vein Thrombosis ◽

Enhanced Ct ◽

Deep Vein

Abstract Background Incidence of venous thromboembolism (VTE) after esophagectomy is higher than those in other gastroenterological cancer surgery. However, the strategy of thromboprophylaxis during esophagectomy has not been established. Although effectiveness and safety of thromboprophylaxis using enoxaparin have been established in orthopedic, abdominal, and pelvic surgeries, no studies are available regarding esophagectomy. Methods We conducted a prospective observational study to elucidate the usefulness of enoxaparin to prophylactic VTE after esophagectomy. Thirty patients who underwent elective three-incision esophagectomy for esophageal cancer between April 2015 and October 2016 were enrolled. During the postoperative day (POD) 2 to 11, patients received a subcutaneous injection of enoxaparin (2000 IU) twice daily. The primary endpoint was the incidence of postoperative VTE. In addition, the incidence of all enoxaparin treatment-related and operation-related adverse events were also investigated. VTE was identified by VTE protocol enhanced CT, which was routinely performed during enoxaparin treatment and after enoxaparin treatment. Results One pulmonary embolism (PE) (3.3%) and 2 deep vein thrombosis (DVT) (6.7%) were observed during enoxaparin treatment. In addition, further one PE (3.6%) and 4 DVTs (14.3%) (one patient suffered the both) were observed after treatment. All VTEs were asymptomatic. Regarding enoxaparin-related adverse events, 4 minor bleedings without a need of stopping enoxaparin occurred. Incidence of postoperative morbidity was acceptable. In blood tests related to coagulation system, no significant differences were observed between patients with and without VTE. Conclusion We believe that thromboprophylaxis using enoxaparin is safe and can prevent VTE after esophagectomy. However, the effectiveness is limited in the period of treatment, additional prophylaxis following enoxaparin treatment may be recommended. Disclosure All authors have declared no conflicts of interest.

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5-Hydroxytryptamine-3 Receptor Antagonist and Dexamethasone as Prophylaxis for Chemotherapy Induced Nausea and Vomiting during Moderately Emetic Chemotherapy for Solid Tumors: A Multicenter, Prospective, Observational Study

10.21203/rs.3.rs-16203/v2 ◽

2020 ◽

Author(s):

Reiko Matsui ◽

Kenichi Suzuki ◽

Tomomi Takiguchi ◽

Makoto Nishio ◽

Takeshi Koike ◽

...

Keyword(s):

Risk Factors ◽

Lung Cancer ◽

Observational Study ◽

Receptor Antagonist ◽

Motion Sickness ◽

Prospective Observational Study ◽

Nausea And Vomiting ◽

History Of ◽

Independent Risk Factors ◽

Multicenter Prospective Observational Study

Abstract Background: Of patients receiving moderate emetic risk chemotherapy (MEC), 30%–90% experience chemotherapy-induced nausea and vomiting (CINV); however, the optimal antiemetic treatment remains controversial. Methods: In this multicenter, prospective, observational study of adults treated with MEC while receiving chemotherapy for various cancer types in Japan, the enrolled patients kept diaries documenting CINV. All participants received a 5-hydroxytryptamine-3 receptor antagonist and dexamethasone. Results: Of the 400 patients enrolled from May 2013 to January 2015, 386 were eligible for evaluation. The median age was 64 (range, 26–84). The overall complete response (CR; no emetic events and no antiemetic measures) rate was 64%. The proportion of patients showing CR was low in the carboplatin (CBDCA)- and oxaliplatin-based chemotherapy groups, especially among women. We showed that the CR rates in men were high in the CBDCA (AUC5) + etoposide (ETP) (80%), capecitabine plus oxaliplatin (CAPOX) (78%), and CBDCA+ paclitaxel (PTX) groups for lung cancer (73%). Total control (TC; no emetic events, no antiemetic measures, and no nausea) and complete control (CC; no emetic events, no antiemetic measures, and less than mild nausea) were achieved in 51% and 61% of patients, respectively. Logistic regression analysis revealed that no history of motion sickness, no history of pregnancy-associated vomiting, and non-CBDCA-based chemotherapy are independent risk factors for CR, whereas no history of motion sickness and no history of pregnancy-associated vomiting are independent risk factors for TC. Conclusion: Our data showed that two antiemetics were insufficient to control CINV in patients receiving CBDCA- or oxaliplatin-based chemotherapy. However, two antiemetics may be sufficiently effective for elderly male patients receiving CBDCA (AUC5)+ETP, CBDCA+PTX for lung cancer, or CAPOX. Additionally, we consider that three antiemetics are necessary for women with colorectal cancer receiving CAPOX. Risk factor analysis related to CR showed that CINV prophylaxis in patients treated with CBDCA-based chemotherapy was generally supportive of the guideline-recommended three antiemetics. However, the control of nausea in patients receiving non-CBDCA-based chemotherapy is a key point to note. The further individualization of antiemetic regimens for patients receiving MEC based on both types of chemotherapy regimens and sex is needed.

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