Prophylaxis for venous thromboembolism after resection of hepatocellular carcinoma on cirrhosis: Is it necessary?

Table 1 Baseline characteristics of the study population (mean ± SD) n (%)

Variables	All patients (n = 229)	Group A (n = 157)	Group B (n = 72)	P value
Age (yr)	65.0 ± 9.3	65.0 ± 9.8	63.0 ± 9.5	0.080
Gender (M/F)	171 (74.7)/ 58 (25.3)	119 (76.0)/ 38 (24.0)	52 (72.0)/20 (28.0)	0.330
Etiology of cirrhosis				0.200
Hepatitis C	148 (64.6)	106 (67.0)	42 (58.3)
Hepatitis B	37 (16.2)	21 (14.0)	16 (22.2)
Hepatitis B + C	15 (6.6)	7 (5.0)	8 (11.1)
Non-viral	29 (12.7)	23 (14.0)	6 (8.3)
Child-Pugh score				0.005
A	218 (95.2)	154 (98.0)	64 (89.0)
B	11 (4.8)	3 (2.0)	8 (11.0)
C	0
MELD score	8.8 ± 1.5	8.5 ± 1.2	9.3 ± 1.9	0.001
Platelet count (× 103)	139 ± 60	150 ± 60	115 ± 51	0.001
Esophageal varices	63 (28.0)	34 (22.0)	29 (40.3)	0.003

MELD: Model for end-stage liver disease.

Table 2 Details of surgery performed in the two groups

Variables	All patients (n = 229)	Group A (n = 157)	Group B (n = 72)	P value
Type of resection n (%)				0.610
Minor	219 (95.0)	150 (95.5)	69 (95.8)
Major	10 (5.0)	7 (4.5)	3 (4.2)
Duration of surgery (mean ± SD)	266 ± 99	261 ± 106	275 ± 83	0.320
i.o. blood transfusion [mL, median (range)]	128.2 (0-1500)	124.7 (0-1500)	154.1 (0-1200)	0.346
i.o. FFP transfusion [mL, median (range)]	175.7 (0-1200)	139.5 (0-1200)	266.6 (0-1200)	0.003

i.o.: Intraoperative; FFP: Fresh frozen plasma.

Table 3 Specific risk factors for venous thromboembolism in the two groups n (%)

Variables	All patients (n = 229)	Group A (n = 157)	Group B (n = 72)	P value
BMI > 30 kg/m2	36 (17.1)	26 (17.8)	10 (15.4)	0.410
Diabetes	47 (20.5)	33 (21.0)	14 (19.4)	0.460
Cardiovascular disease	56 (24.5)	43 (27.0)	13 (18.1)	0.080

BMI: Body mass index.

Table 4 Analysis of possible risk factors for venous thromboembolism

Variable	Exp (B)	95% CI	P value
Child-Pugh score (score A vs B)	0.004	0.00-15.32	0.906
MELD score	1.748	0.96-3.16	0.132
Type of resection (minor vs major)	0.004	0.00-17.52	0.914
Platelet count	0.990	0.99-1.00	0.776
Esophageal varices	0.001	0.00-18.22	0.525
BMI	0.001	0.00-11.45	0.687
Diabetes	0.001	0.00-12.45	0.631
Cardiovascular disease	0.001	0.00-19.31	0.570
Duration of surgery	0.997	0.98-1.01	0.720
i.o. blood transfusion (mL)	1.000	0.99-1.00	0.490
i.o. FFP transfusion (mL)	1.001	0.99-1.00	0.518
VTE prophylaxis	0.455	0.02-7.38	0.531

VTE: Venous thromboembolism.

Table 5 Analysis of possible risk factors for hemorrhagic complications

Variable	Exp (B)	95% CI	P value
Child-Pugh score (score A vs B)	0.004	0.00-23.72	0.742
MELD score	1.280	0.83-1.95	0.252
Type of resection (minor vs major)	0.004	0.00-20.75	0.763
Platelet count	0.987	0.99-1.02	0.445
Esophageal varices	5.559	0.99-31.14	0.050
BMI	0.000	0.00-27.45	0.389
Diabetes	0.000	0.00-24.28	0.248
Cardiovascular disease	1.564	0.27-8.77	0.454
Duration of surgery	0.997	0.98-1.00	0.460
i.o. blood transfusion (mL)	1.001	0.99-1.00	0.315
i.o. FFP transfusion (mL)	1.002	0.98-1.00	0.073
VTE prophylaxis	0.443	0.26-20.42	0.387