12 risk factors linked to postoperative VTE in gynaecologic malignancy patients

Several factors tend to increase the risk of venous thromboembolism (VTE) in patients with gynaecologic malignant tumours after surgery, reveals a study.

A team of investigators searched the databases of China Knowledge, Wanfang, Wipro, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of Science from inception to March 2025 for cohort and case-control studies on the risk factors of postoperative VTE in patients with gynaecologic malignancy.

Nine studies, including a total of 123,329 patients, met the eligibility criteria. Data were analysed using the RevMan 5.2 software.

Advanced age (odds ratio [OR], 3.08, 95 percent confidence interval [CI], 2.85‒3.32; p<0.00001), open surgery (OR, 9.18, 95 percent CI, 2.38‒35.34; p=0.001), high surgical complexity (OR, 9.97, 95 percent CI, 5.80‒17.15; p<0.00001), and surgical duration (OR, 3.33, 95 percent CI, 2.97‒3.73; p<0.00001) correlated with a higher likelihood of postoperative VTE.

Likewise, high BMI (OR, 4.77, 95 percent CI, 3.47‒6.57; p<0.00001), comorbidities (OR, 21.02, 95 percent CI, 8.72‒50.70; p<0.00001), prolonged bed rest after surgery (OR, 25.16, 95 percent CI, 10.32‒61.32; p<0.00001), and high intraoperative bleeding (OR, 107.53, 95 percent CI, 17.71‒652.85; p<0.00001) were significantly associated with postoperative VTE risk.

Other factors that seemed to contribute to VTE risk in patients with gynaecologic malignancy were high D-dimer level (OR, 5.55, 95 percent CI, 3.27‒9.43; p<0.00001), advanced tumour stage (OR, 7.58, 95 percent CI, 2.22‒25.90; p=0.001), high tumour grade (OR, 27.67, 95 percent CI, 8.39‒91.18; p<0.00001), and occurrence of lymph node metastasis (OR, 31.21, 95 percent CI, 9.54‒102.15; p<0.00001).

“Clinical staff should take into account the 12 risk factors identified in this study to actively identify gynaecologic malignant tumour patients at high risk for VTE after surgery and provide targeted measures to prevent or reduce [such risk],” the investigators said.