Clinical and laboratory characteristics of surgical patients with MPN at time of intervention
| Variables . | Procedures in all (N = 354) . | Procedures in PV (n = 149 [42%]) . | Procedures in ET (n = 121 [34%]) . | Procedures in MF (n = 84 [24%]) . | P value . |
|---|---|---|---|---|---|
| Age at time of surgery, median (range), y | 72 (25-95) | 72 (38-93) | 73 (25-95) | 71 (52-91) | .4 |
| Major surgery, n (%) | 77 (22) | 45 (30) | 17 (14) | 15 (18) | .004 |
| Major surgery type, n (%) | .4 | ||||
| General | 55 (71) | 31 (69) | 12 (71) | 12 (80) | |
| Orthopedic | 17 (22) | 12 (27) | 4 (24) | 1 (7) | |
| Cardiovascular | 5 (6) | 2 (4) | 1 (6) | 2 (13) | |
| Urgent/semiurgent procedure, n (%) | 80 (23) | 41 (28) | 19 (16) | 20 (24) | .06 |
| Procedure types (minor), n (%) | .01 | ||||
| Cardiopulmonary | 16 (6) | 11 (10) | 4 (4) | 1 (1) | |
| Dermatologic | 19 (7) | 4 (4) | 8 (8) | 7 (10) | |
| Endoscopy ± biopsy | 113 (41) | 30 (29) | 47 (45) | 36 (52) | |
| Miscellaneous | 39 (14) | 20 (19) | 13 (12) | 6 (9) | |
| Ophthalmologic | 38 (14) | 18 (17) | 15 (14) | 5 (7) | |
| Orthopedic | 10 (3) | 6 (6) | 2 (2) | 2 (3) | |
| Tumor resection | 30 (11) | 9 (8) | 11 (11) | 10 (14) | |
| Urologic | 12 (4) | 6 (6) | 4 (4) | 2 (3) | |
| General anesthesia, n (%) N evaluable = 195 (55%) | 79 (40) | 49 (42) | 17 (35) | 13 (46) | .6 |
| Blood counts at time of surgery; median (range) | |||||
| Leukocytes, × 109/L; N = 324 (92%) | 7.6 (1.6-99.5) | 8.4 (2.7-56) | 6.3 (2.3-24.8) | 11.1 (1.6-99.5) | <.0001 |
| Hemoglobin, g/L; N = 324 (92%) | 127 (69-194) | 136 (72-194) | 127 (89-162) | 106 (69-155) | <.0001 |
| Hct, %; N = 315 (89%) | 38.9 (20-59.1) | 41.4 (21.2-59.1) | 39 (26-48.4) | 32 (20-45.2) | <.0001 |
| PLTs, × 109/L; N = 322 (91%) | 318 (27-1039) | 265 (38-1010) | 365 (27-1039) | 239 (32-649) | <.0001 |
| Preoperative therapy, n (%) | |||||
| Antiplatelet; N = 326 (92%) | 255 (78) | 112 (88) | 100 (84) | 43 (54) | <.0001 |
| Cytoreduction; N = 336 (95%) | 264 (79) | 104 (76) | 104 (87) | 56 (69) | .005 |
| Anticoagulation; N = 296 (84%) | 29 (10) | 15 (15) | 12 (10) | 2 (3) | <.01 |
| Type of cytoreduction | <.0001 | ||||
| Hydroxyurea | 177 (67) | 92 (88) | 74 (72) | 11 (20) | |
| Ruxolitinib | 45 (17) | 10 (10) | - | 35 (63) | |
| Anagrelide | 15 (6) | - | 13 (13) | 2 (4) | |
| Busulfan | 9 (3) | - | 9 (9) | - | |
| Combination | 17 (6) | 2 (2) | 7 (7) | 8 (14) | |
| Preoperative therapy modification, n (%) | |||||
| Antiplatelet stop presurgery, N = 313 | 138 (44) | 44 (38) | 46 (40) | 48 (60) | .004 |
| Cytoreduction modification, N = 236 | .01 | ||||
| Continue/start preop | 202 (86) | 71 (78) | 83 (88) | 48 (94) | |
| Stop | 29 (12) | 18 (20) | 10 (11) | 1 (2) | |
| Dose modify | 5 (2) | 2 (2) | 1 (1) | 2 (4) | |
| Anticoagulation stop presurgery, N = 34 | 16 (47) | 12 (60) | 4 (31) | 0 (0) | .1 |
| Postoperative anticoagulation prophylaxis; n (%), N = 182 (51%) | 42 (23) | 20 (20) | 13 (24) | 9 (35) | .3 |
| Surgical bleeding; n (%), N = 329 (93%) | 8 (2) | 7 (6) | 0 | 1 (1) | .006 |
| Arterial thrombosis (90-d postoperative); n (%), N = 333 (94%) | 3 (1) | 0 | 1 (1) | 2 (2) | .15 |
| Venous thrombosis (90-d postoperative); n (%), N = 334 (94%) | 3 (1) | 2 (2) | 1 (1) | 0 | .4 |
| Hemorrhage (90-d postoperative); n (%), N = 327 (93%) | 21 (6) | 9 (6) | 5 (4) | 7 (8) | .5 |
| Any perioperative bleed; n (%), N = 327 (93%) | 28 (8) | 15 (12) | 5 (4) | 8 (10) | .07 |
| Any perioperative complication (composite end point) | 38 (11) | 18 (14) | 9 (7) | 11 (13) | .21 |
| Death (90-d postoperative); n (%) | 4 (1) | 1 (1) | 2 (2) | 1 (1) | .8 |
| Variables . | Procedures in all (N = 354) . | Procedures in PV (n = 149 [42%]) . | Procedures in ET (n = 121 [34%]) . | Procedures in MF (n = 84 [24%]) . | P value . |
|---|---|---|---|---|---|
| Age at time of surgery, median (range), y | 72 (25-95) | 72 (38-93) | 73 (25-95) | 71 (52-91) | .4 |
| Major surgery, n (%) | 77 (22) | 45 (30) | 17 (14) | 15 (18) | .004 |
| Major surgery type, n (%) | .4 | ||||
| General | 55 (71) | 31 (69) | 12 (71) | 12 (80) | |
| Orthopedic | 17 (22) | 12 (27) | 4 (24) | 1 (7) | |
| Cardiovascular | 5 (6) | 2 (4) | 1 (6) | 2 (13) | |
| Urgent/semiurgent procedure, n (%) | 80 (23) | 41 (28) | 19 (16) | 20 (24) | .06 |
| Procedure types (minor), n (%) | .01 | ||||
| Cardiopulmonary | 16 (6) | 11 (10) | 4 (4) | 1 (1) | |
| Dermatologic | 19 (7) | 4 (4) | 8 (8) | 7 (10) | |
| Endoscopy ± biopsy | 113 (41) | 30 (29) | 47 (45) | 36 (52) | |
| Miscellaneous | 39 (14) | 20 (19) | 13 (12) | 6 (9) | |
| Ophthalmologic | 38 (14) | 18 (17) | 15 (14) | 5 (7) | |
| Orthopedic | 10 (3) | 6 (6) | 2 (2) | 2 (3) | |
| Tumor resection | 30 (11) | 9 (8) | 11 (11) | 10 (14) | |
| Urologic | 12 (4) | 6 (6) | 4 (4) | 2 (3) | |
| General anesthesia, n (%) N evaluable = 195 (55%) | 79 (40) | 49 (42) | 17 (35) | 13 (46) | .6 |
| Blood counts at time of surgery; median (range) | |||||
| Leukocytes, × 109/L; N = 324 (92%) | 7.6 (1.6-99.5) | 8.4 (2.7-56) | 6.3 (2.3-24.8) | 11.1 (1.6-99.5) | <.0001 |
| Hemoglobin, g/L; N = 324 (92%) | 127 (69-194) | 136 (72-194) | 127 (89-162) | 106 (69-155) | <.0001 |
| Hct, %; N = 315 (89%) | 38.9 (20-59.1) | 41.4 (21.2-59.1) | 39 (26-48.4) | 32 (20-45.2) | <.0001 |
| PLTs, × 109/L; N = 322 (91%) | 318 (27-1039) | 265 (38-1010) | 365 (27-1039) | 239 (32-649) | <.0001 |
| Preoperative therapy, n (%) | |||||
| Antiplatelet; N = 326 (92%) | 255 (78) | 112 (88) | 100 (84) | 43 (54) | <.0001 |
| Cytoreduction; N = 336 (95%) | 264 (79) | 104 (76) | 104 (87) | 56 (69) | .005 |
| Anticoagulation; N = 296 (84%) | 29 (10) | 15 (15) | 12 (10) | 2 (3) | <.01 |
| Type of cytoreduction | <.0001 | ||||
| Hydroxyurea | 177 (67) | 92 (88) | 74 (72) | 11 (20) | |
| Ruxolitinib | 45 (17) | 10 (10) | - | 35 (63) | |
| Anagrelide | 15 (6) | - | 13 (13) | 2 (4) | |
| Busulfan | 9 (3) | - | 9 (9) | - | |
| Combination | 17 (6) | 2 (2) | 7 (7) | 8 (14) | |
| Preoperative therapy modification, n (%) | |||||
| Antiplatelet stop presurgery, N = 313 | 138 (44) | 44 (38) | 46 (40) | 48 (60) | .004 |
| Cytoreduction modification, N = 236 | .01 | ||||
| Continue/start preop | 202 (86) | 71 (78) | 83 (88) | 48 (94) | |
| Stop | 29 (12) | 18 (20) | 10 (11) | 1 (2) | |
| Dose modify | 5 (2) | 2 (2) | 1 (1) | 2 (4) | |
| Anticoagulation stop presurgery, N = 34 | 16 (47) | 12 (60) | 4 (31) | 0 (0) | .1 |
| Postoperative anticoagulation prophylaxis; n (%), N = 182 (51%) | 42 (23) | 20 (20) | 13 (24) | 9 (35) | .3 |
| Surgical bleeding; n (%), N = 329 (93%) | 8 (2) | 7 (6) | 0 | 1 (1) | .006 |
| Arterial thrombosis (90-d postoperative); n (%), N = 333 (94%) | 3 (1) | 0 | 1 (1) | 2 (2) | .15 |
| Venous thrombosis (90-d postoperative); n (%), N = 334 (94%) | 3 (1) | 2 (2) | 1 (1) | 0 | .4 |
| Hemorrhage (90-d postoperative); n (%), N = 327 (93%) | 21 (6) | 9 (6) | 5 (4) | 7 (8) | .5 |
| Any perioperative bleed; n (%), N = 327 (93%) | 28 (8) | 15 (12) | 5 (4) | 8 (10) | .07 |
| Any perioperative complication (composite end point) | 38 (11) | 18 (14) | 9 (7) | 11 (13) | .21 |
| Death (90-d postoperative); n (%) | 4 (1) | 1 (1) | 2 (2) | 1 (1) | .8 |