The efficacy and safety of direct oral anticoagulants compared with low‐molecular‐weight heparin for venous thromboembolism prophylaxis after surgical resection of primary lower extremity bone or soft‐tissue sarcoma

Introduction The incidence of postoperative venous thromboembolism (VTE) and wound complications is greater after sarcoma resection. We sought to identify differences in postoperative VTE and bleeding complications with direct oral anticoagulants (DOACs) versus low‐molecular‐weight heparin (LMWH) fo...

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Bibliographic Details
Published in:Journal of surgical oncology 2024-03, Vol.129 (3), p.537-543
Main Authors: LiBrizzi, Christa L., Agarwal, Amil R., Chiu, Anthony K., Morris, Carol D., Thakkar, Savyasachi C., Levin, Adam S.
Format: Article
Language:English
Subjects:
Anticoagulants
Anticoagulants - adverse effects
DOAC
embolism
heparin
Heparin, Low-Molecular-Weight - adverse effects
Humans
Lower Extremity - surgery
Postoperative Complications - drug therapy
Postoperative Complications - epidemiology
Postoperative Complications - prevention & control
Pulmonary Embolism - epidemiology
Retrospective Studies
Sarcoma
Sarcoma - drug therapy
Sarcoma - surgery
Soft Tissue Neoplasms - drug therapy
Thromboembolism
thromboprophylaxis
thrombosis
Venous Thromboembolism - epidemiology
Venous Thromboembolism - etiology
Venous Thromboembolism - prevention & control
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Summary:Introduction The incidence of postoperative venous thromboembolism (VTE) and wound complications is greater after sarcoma resection. We sought to identify differences in postoperative VTE and bleeding complications with direct oral anticoagulants (DOACs) versus low‐molecular‐weight heparin (LMWH) following resection of lower extremity primary bone or soft tissue sarcoma. Methods We retrospectively identified 2083 patients from the PearlDiver database who underwent resection of primary bone or soft tissue sarcoma of the lower extremity from January 2010 to October 2021 and prescribed LMWH or DOAC within 90‐days postoperatively. The primary outcomes were comparison of postoperative incidence and odds of deep venous thrombosis (DVT), pulmonary embolism (PE), and bleeding complications within 90‐days following resection. Results Patients prescribed DOACs had a greater odds of DVT (odds ratio [OR]: 1.60; 95% confidence interval [CI]: 1.06–2.41; p = 0.024) and PE (OR: 3.38; 95% CI: 1.96–5.86; p 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.27519