Key result
Elevated postoperative serum FVIII:C levels (≥150 IU/dL) were associated with a significantly increased risk of deep vein thrombosis compared to levels <100 IU/dL (OR 2.99) following gynecological surgery.
Why the study?
Deep vein thrombosis is common following gynecological surgery, but the correlation with serum factor VIII:C levels required evaluation.
Do elevated serum FVIII:C levels increase the risk of deep vein thrombosis in patients following gynecological surgery?
Cohort (n=800)
No
Do elevated serum FVIII:C levels increase the risk of deep vein thrombosis in patients following gynecological surgery?
Elevated postoperative serum FVIII:C levels are an independent, dose-dependent risk factor for deep vein thrombosis following gynecological surgery.
Deep vein thrombosis (DVT) is common in patients following gynecological surgery. Coagulation factor VIII (FVIII) is an important part of the human coagulation system, and FVIII:C is a component of FVIII with anticoagulant activity. 800 patients who underwent gynecological surgery were enrolled. General clinical data were harvested, and pre – and postoperative serum FVIII levels were determined. Lower-extremity ultrasound examination and/or postoperative pulmonary angiography were performed. Related data were analyzed statistically. DVT was the first manifestation of venous thromboembolism in all cases. There were a total of 46 cases, and the incidence of DVT was 5.8%. Progression to pulmonary embolism was confirmed in 16 cases, with an incidence of 2.0%. The independent risk factors for DVT after gynecological surgery were postoperative FVIII:C levels (odds ratio [OR] = 1.01), age (OR = 6.57), and operation time ≥3 hours (OR = 2.90) (P < 0.05). When the FVIII:C level was greater than the 75th centile (≥150 IU/dL), the risk of DVT was 2.99 times higher than that below the 25th centile (<100 IU/dL) (P < 0.05). When combined with the risk factor of operation time ≥3 hours, the risk increased to 3.17 times (P = 0.10). When combined with age ≥60 years, the risk was significantly increased, reaching 12.0 times (P < 0.05). Serum FVIII:C levels are an independent risk factor for DVT after gynecological surgery. Higher levels increase the risk of DVT after gynecological surgery, and they may have a dose-dependent relationship. A synergistic effect exists in combination with other risk factors, which further increases the risk.
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Liu et al. (2021) conducted a cohort in Deep vein thrombosis following gynecological surgery (n=800). Elevated postoperative serum FVIII:C levels (≥150 IU/dL) vs. Low serum FVIII:C levels (<100 IU/dL) was evaluated on Deep vein thrombosis (DVT) (OR 2.99, 95% CI 1.27-7.99, p=<0.05). Elevated postoperative serum FVIII:C levels (≥150 IU/dL) were associated with a significantly increased risk of deep vein thrombosis compared to levels <100 IU/dL (OR 2.99) following gynecological surgery.
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