Predictors of post-gastrectomy venous thromboembolism in patients with gastric adenocarcinoma: a retrospective study

Background and objectives. This study aimed to delineate perioperative risk factors for venous thromboembolism (VTE) after gastrectomy in patients with gastric adenocarcinoma. Materials and methods. A total of 170 patients with gastric adenocarcinoma underwent gastrectomy at the general surgery department of Benha University Hospital. Among them, 60 patients with elevated D-dimer levels on postoperative day 1 (POD1) underwent duplex ultrasonography of the lower and upper extremity veins. Clinical and pathological data were collected, and differences between the postoperative VTE-negative (−) and VTE-positive (+) groups were analyzed. Univariate and multivariate logistic regression models were used to identify predictors of VTE following gastrectomy. Results. Of the 60 patients with elevated D-dimer levels, 19 were diagnosed with deep venous thrombosis (DVT) involving both lower and upper extremity veins. Among these, 16 patients (84.2%) had DVT in the lower extremities, and 3 patients (15.8%) in the upper extremities. The VTE (+) group showed significant preoperative differences in age (p = 0.01), BMI (p = 0.04), white blood cell count (p = 0.03), D-dimer levels (p = 0.03), blood glucose concentration (p = 0.01), and Caprini score (p = 0.03). Postoperatively, hemoglobin levels were significantly lower in the VTE (+) group (p = 0.02). Pathologically, deeper tumor invasion (p = 0.02) and more advanced tumor, node, and TNM stages (p = 0.01) were observed. Univariate logistic regression identified age, preoperative blood glucose levels, Caprini score, postoperative hemoglobin, invasion depth, and TNM stage as significant predictors of VTE. Multivariate analysis confirmed age, TNM stage, and Caprini score as independent predictors of VTE following gastrectomy. Conclusion. Age, preoperative blood glucose levels, Caprini score, postoperative hemoglobin reduction, invasion depth, and TNM stage were identified as independent prognostic indicators for VTE after gastrectomy in patients with gastric adenocarcinoma. These findings highlight the importance of comprehensive perioperative risk evaluation and management to prevent VTE in this population.