Risk factors for lower limb deep vein thrombosis after thoracic surgery: a retrospective single-center study

This study aims to determine the incidence of lower limb deep vein thrombosis (DVT) after thoracic surgery and explore its association with coagulation indicators. A retrospective analysis was conducted on 114 patients who underwent thoracic surgery and received mechanical prophylaxis (e.g., compression stockings) from April to June 2025. Cases with complete data on lower limb venous ultrasound, blood routine, conventional coagulation tests(prothrombin time, International normalized ratio, Activated partial thromboplastin time, Fibrinogen, Thrombin time), and were included in the study. The study analyzed the general information, surgical methods, pathology, and coagulation indicators of patients who developed thrombosis. A total of 114 patients were included, ranging in age from 16 to 84 years, with 64 males and 50 females. Among them, 28 patients (24.56%) developed calf deep vein thrombosis, with postoperative DVT rate of 21.88% (14/64) in males and 28.00% (14/50) in females. The DVT incidence in patients with malignant tumors was 27.14% (19/70), while it was 20.46% (9/44) in those without malignant tumors. The incidence of smoking history was 14.29% (5/35), and the incidence without smoking history was 29.11% (23/79). The BMI, platelet count, conventional coagulation tests, and were compared between the groups that developed thrombosis and those that did not. Significant differences were observed in age and thrombelastogram(TEG) parameters(e.g., R, K,α Angle, MA) between the two groups, while no other factors showed statistical significance. Despite mechanical prophylaxis, lower limb DVT remains common after thoracic surgery, particularly among women and patients with malignancies. Age and TEG parameters showed predictive value, underscoring the need for postoperative ultrasound screening and potential consideration of pharmacologic prophylaxis.