How Often is Asymptomatic DVT Found in Elective General Surgery for Benign Disease?

The incidence of asymptomatic deep vein thrombosis (DVT) was equal in patients with and without malignant diseases undergoing elective general surgery for benign disease, according to authors of a retrospective observational study published in the Annals of Gastroenterological Surgery.

“Preoperative DVT assessment is thus considered to be necessary regardless of the disease for which surgery is indicated, especially in patients with the risk factors identified in this study,” concluded the authors, led by Ken Hagiwara, MD, of the Department of Surgery at Nihon University School of Medicine in Tokyo, Japan. The identified risk factors included advanced age, female sex, and decreased hemoglobin levels.

Patients with Benign Disease Have Preoperative DVT Rate Similar to Malignant Disease

Researchers reviewed 1,512 patients who received elective general surgery between January 2011 and September 2020 with lower extremity venous ultrasonography screening for DVT prior to surgery. Among the 1,512 patients, 161 (10.6%) had preoperative asymptomatic DVT identified during screening.

The prevalence of DVT in patients with malignant disease was 13.7% compared with 8.6% in patients with benign disease. The thrombus was distal type in 141 (87.6%) patients, and was most commonly located in the soleal vein.

Age over 70 years, female sex, and decreased hemoglobin level were all significantly associated with preoperative asymptomatic DVT based on multivariate analysis. Advanced age showed the highest odds ratio for preoperative DVT, and the odds rose as age increased. Malignant disease was not an independent risk factor for preoperative DVT, investigators noted.

Given that anemia is linked to underlying conditions associated with venous thromboembolism, the report suggested a decreased hemoglobin level may also call for additional comorbidity assessments beyond DVT screening regardless of the primary reason for surgical intervention.

Overall, “the prevalence of asymptomatic DVT to be equivalent in patients with malignant and benign diseases undergoing elective general surgery,” Dr. Hagiwara and colleagues concluded.

Reference

Hagiwara K, Watanabe Y, Suzuki T, et al. Prevalence of preoperative asymptomatic deep vein thrombosis in patients undergoing elective general surgery for benign disease. Ann Gastroenterol Surg. 2023;7(6):1042-1048. 2023; doi:10.1002/ags3.12709

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