Black Patients with Lung Cancer at Higher Risk of Postoperative Blood Clots

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Venous thromboembolism (VTE), a blood clot forming in a vein that can lead to pulmonary embolism, may be a major complication for lung cancer patients after they received a pulmonary resection procedure.

Recent research additionally showed patients who experienced a postoperative pulmonary embolism had a higher risk of death, reintubation and hospital readmission for 30 days afterward. Among the highest risk factors for embolism included Black race and an interstitial fibrosis diagnosis.

A team of investigators analyzed data collected from the STS’s General Thoracic Surgery Database (GTSD), that contains more than 700,000 procedure records from more than 1,000 participating surgeons. The team searched for anonymous results for 57,531 adult patients who underwent pulmonary resection between January 2009 and June 2021.

Among this population, 758 patients developed blood clots that moved to the lungs after surgery – these patients were more likely to be Black (12 percent) versus other races (7 percent). Vulnerable patients were also more likely to have interstitial fibrosis or scarring and inflammation of the lung. Overall, those with more advanced disease, as well as those who underwent bilobectomy or pneumonectomy, were more likely to develop pulmonary embolism.

The team also found a 2.5 percent occurrence of postoperative VTE and a 1.3 percent occurrence of postoperative pulmonary embolism in patients undergoing a first-time pulmonary resection for lung cancer. The time-over-time trends suggest the incidence of postoperative VTE to remain largely unchanged over the 12-year study period.

However, in that period, the associated mortality rate decreased from 20 percent in 2009 to 8 percent in 2018. Investigators observed no difference in pulmonary embolism risk according to lung function before surgery, cancer cell type, or receipt of chemotherapy before surgery.

A previous analysis from the Centers for Disease Control and Prevention (CDC) found Black individuals in the United States experienced a 40 percent higher incidence of VTE overall, compared with White individuals. Further data reported a nearly three-fold increased odds of VTE in patients with lung cancer. Thus, the team indicated Black race as a predisposing factor for VTE was confirmed by their analysis findings.

“While this difference is likely multi-factorial, previous investigations have suggested genetic variability, socioeconomic factors, and health disparities in access to high-volume, subspecialized care,” investigators wrote.

The investigators indicated further steps for individuals at risk for embolism after pulmonary resection for lung cancer could include more imaging, particularly in the legs where blood clots form, or a longer course of blood thinners to prevent clot formation occurrences.

“By increasing awareness of the increased risk for VTE in Black patients, the team hopes to encourage more focused preventative measures in these patients,” they wrote.

This article was originally published on sister site HCPLive.