Статья

Antithrombotic prophylaxis for surgery-associated venous thromboembolism risk disorders. In patients the SPATA-DVT with inherited Study platelet

F. Paciullo, L. Bury, P. Noris, E. Falcinelli, F. Melazzini, S. Orsini, C. Zaninetti, R. Abdul-Kadir, D. Obeng-Tuudah, P. Heller, A. Glembotsky, F. Fabris, J. Rivera, M. Lozano, N. Butta, R. Favier, A. Cid, M. Fouassier, G. Podda, C. Santoro, E. Grandone, Y. Henskens, P. Nurden, B. Zieger, A. Cuker, K. Devreese, A. Tosetto, E. de Candia, A. Dupuis, K. Miyazaki, M. Othman, P. Gresele,
2020

Major surgery is associated with an increased risk of venous thromboembolism (VTE), thus the application of mechanical or pharmacologic prophylaxis is recommended. The incidence of VTE in patients with inherited platelet disorders (IPD) undergoing surgical procedures is unknown and no information on the current use and safety of thromboprophylaxis, particularly of low-molecular-weight-heparin in these patients is available. Here we explored the approach to thromboprophylaxis and thrombotic outcomes in IPD patients undergoing surgery at VTE-risk participating in the multicenter SPATA study. We evaluated 210 surgical procedures carried out in 155 patients with well-defined forms of IPD (VTE-risk: 31% high, 28.6% intermediate, 25.2% low, 15.2% very low). The use of thromboprophylaxis was low (23.3% of procedures), with higher prevalence in orthopedic and gynecological surgeries, and was related to VTE-risk. The most frequently employed thromboprophylaxis was mechanical and appeared to be effective, as no patients developed thrombosis, including patients belonging to the highest VTE-risk classes. Low-molecular-weight-heparin use was low (10.5%) and it did not influence the incidence of post-surgical bleeding or of antihemorrhagic prohemostatic interventions use. Two thromboembolic events were registered, both occurring after high VTE-risk procedures in patients who did not receive thromboprophylaxis (4.7%). Our findings suggest that VTE incidence is low in patients with IPD undergoing surgery at VTE-risk and that it is predicted by the Caprini score. Mechanical thromboprophylaxis may be of benefit in patients with IPD undergoing invasive procedures at VTE-risk and low-molecular-weight-heparin should be considered for major surgery.

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  • 1. Version of Record от 2020-07-01

Метаданные

Об авторах
  • F. Paciullo
    Università degli Studi di Perugia
  • L. Bury
    Università degli Studi di Perugia
  • P. Noris
    Università degli Studi di Pavia
  • E. Falcinelli
    Università degli Studi di Perugia
  • F. Melazzini
    Università degli Studi di Pavia
  • S. Orsini
    Università degli Studi di Perugia
  • C. Zaninetti
    Università degli Studi di Pavia, Università degli Studi di Pavia
  • R. Abdul-Kadir
    University College London
  • D. Obeng-Tuudah
    University College London
  • P. Heller
    Instituto de Investigaciones Medicas Alfredo Lanari, Instituto de Investigaciones Medicas Alfredo Lanari
  • A. Glembotsky
    Instituto de Investigaciones Medicas Alfredo Lanari, Instituto de Investigaciones Medicas Alfredo Lanari
  • F. Fabris
    Azienda Ospedaliera Di Padova
  • J. Rivera
    Centro Regional de Hemodonacion
  • M. Lozano
    Centro Regional de Hemodonacion
  • N. Butta
    Hospital Universitario La Paz
  • R. Favier
    Hôpital Armand-Trousseau
  • A. Cid
    Hospital Universitari i Politècnic La Fe
  • M. Fouassier
    CHU de Nantes
  • G. Podda
    Università degli Studi di Milano
  • C. Santoro
    Sapienza Università di Roma
  • E. Grandone
    IRCCS Casa Sollievo della Sofferenza, Sechenov First Moscow State Medical University
  • Y. Henskens
    Maastricht University
  • P. Nurden
    Centro Regional de Hemodonacion
  • B. Zieger
    Universität Freiburg im Breisgau
  • A. Cuker
    University of Pennsylvania Perelman School of Medicine
  • K. Devreese
    University Hospital of Ghent
  • A. Tosetto
    Ospedale San Bortolo
  • E. de Candia
    Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Rome
  • A. Dupuis
    Université de Strasbourg
  • K. Miyazaki
    Kitasato University School of Medicine
  • M. Othman
    Queen's University, Kingston
  • P. Gresele
    Università degli Studi di Perugia
Название журнала
  • Haematologica
Том
  • 105
Выпуск
  • 7
Страницы
  • 1948-1956
Финансирующая организация
  • Fondazione Telethon
Номер гранта
  • CP14/00024
Тип документа
  • journal article
Тип лицензии Creative Commons
  • CC BY
Правовой статус документа
  • Свободная лицензия
Источник
  • scopus