Risk factors for bleeding in patients receiving fondaparinux after colorectal cancer surgery


Jongsung Pak, Masataka Ikeda, Mamoru Uemura, Masakazu Miyake, Kazuhiro Nishikawa, Atsushi Miyamoto, Michihiko Miyazaki, Motohiro Hirao, Shoji Nakamori, Mitsugu Sekimoto

Department of Surgery, National Hospital Organization, Osaka National Hospital, Osaka, Japan


Objective: The aim of this study was to identify risk factors for bleeding complications in patients who receive Venous thromboembolism (VTE) prophylaxis with fondaparinux (FPX) after colorectal cancer surgery. Methods: Records of 546 patients who underwent VTE prophylaxis with intermittent pneumatic compression and FPX after colorectal cancer surgery between January 2009 and May 2014 were reviewed. Patient characteristics, surgical procedures, and patient laboratory data were examined to identify risk factors for bleeding complications using univariate and multivariate logistic regression. Results: We reviewed the records of 324 males and 222 females. Median age and BMI were 68.5 years and 22.7 kg/m2, respectively. The number of laparoscopic surgeries was 366. Median operative time and blood loss were 188.5 min and 20 ml, respectively. The incidence (%) of bleeding events was 5.3%. In univariate analysis, age ≥80 years, BMI ≥25.0 kg/m2, hypertension, and antithrombotic therapy were associated with a significantly higher incidence of bleeding events. Multivariate analysis identified age ≥80 years (odds ratio 5.814; 95% confidence interval 2.502-13.278) as an independent risk factor. Conclusion: Age ≥80 is a risk factor for bleeding in patients who receive FPX for VTE prophylaxis after colorectal cancer surgery.

Released: October 30, 2017; doi: dx.doi.org/10.23922/jarc.2017-022