title: Prevalence of deep venous thrombosis detected by ultrasonography before surgery in patients with gastric cancer: a retrospective study of 1140 consecutive patients.
abstract: BACKGROUND
  The prevalence of deep venous thrombosis (DVT) in patients with gastric cancer before surgery is unknown. This study aimed to clarify the risk factors for DVT of the lower extremities in patients with gastric cancer before surgery and to evaluate the usefulness of ultrasonographic screening for prevention of postoperative pulmonary thromboembolism (PTE).
  
  
  METHODS
  Patients who had undergone lower-extremity venous ultrasonography before surgery for gastric cancer were retrospectively analyzed. Univariate and multivariate logistic regression analyses were performed to identify the predictors of DVT before surgery. Perioperative management of patients with DVTs and the incidence of postoperative PTE were investigated.
  
  
  RESULTS
  Of the total 1140 patients, 86 had DVT preoperatively. On univariate analysis, the incidence of DVT was significantly higher with: female sex; age ≥80 years; PS ≥ 1 (vs. PS = 0); stage IV (vs. stages I-III); history of preoperative chemotherapy; and the presence of a central venous catheter (CVC). Multivariate logistic regression analysis demonstrated that sex, age ≥80 years, PS ≥ 1, history of preoperative chemotherapy, and the presence of CVC were significantly correlated with DVT before surgery. Postoperative PTE occurred in 2 patients with proximal DVT. No patients in whom DVT was not detected developed PTE.
  
  
  CONCLUSIONS
  Female sex, older age, worse PS, the presence of CVC, and a history of preoperative chemotherapy were the independent risk factors for DVT. Routine lower-extremity venous ultrasonographic screening is useful for prevention of PTE because it can identify patients at high or low risk for PTE.
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tanizawa
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Etsuro
authors.initials: E
authors.lastname: Bando
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Taiichi
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tokunaga
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Makuuchi
authors.affiliation: Division of Cardiology, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Iida
authors.affiliation: Division of Physiological Examination, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Nanri
authors.affiliation: Division of Physiological Examination, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yoneyama
authors.affiliation: Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. m.terashima@scchr.jp.
authors.forename: Masanori
authors.identifier: http://orcid.org/0000-0002-2967-8267
authors.initials: M
authors.lastname: Terashima
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods; D015995:Prevalence; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D014463:Ultrasonography / Q000379:methods; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology
keywords: Deep venous thrombosis; Gastric cancer; Pulmonary thromboembolism; Ultrasonography