VENOUS THROMBOEMBOLISM IN SMOKERS: CLINICAL COMPLICATIONS AND SURGICAL NEED

Abstract

Venous thromboembolism (VTE) is a medical condition that often goes unnoticed until its devastating effects manifest. Within this group of patients, smokers deserve special attention, since epidemiological studies point to a significant association between smoking and an increased risk of VTE. Objective: to comprehensively analyze the available scientific studies that investigated VTE in smokers, its specific clinical complications and the need for surgical interventions. Methodology: The methodology of this systematic review was based on the PRISMA checklist, the following databases were consulted to identify relevant studies: PubMed, Scielo and Web of Science. The literature search was conducted using five descriptors in English related to the topic: "venous thromboembolism", "deep vein thrombosis", "pulmonary embolism", "smoking" and "surgical intervention”. The inclusion criteria were established based on the guidelines of the PRISMA checklist and included: studies published in English, Portuguese or Spanish, studies that investigated the relationship between smoking and venous thromboembolism, studies that addressed clinical complications associated with VTE in smokers and studies that included a population of patients who were smokers or ex-smokers. Exclusion criteria were as follows: studies that did not specifically address the relationship between smoking and VTE, case reports, case series and narrative reviews, and duplicate or redundant studies. Results: In this systematic review, 15 relevant studies were identified that explored the relationship between venous thromboembolism (VTE) and smoking, focusing on clinical complications and the need for surgical intervention in smoker patients. Studies have highlighted that smokers with VTE face a higher incidence of serious clinical complications, including extensive pulmonary embolism, acute heart failure, and VTE recurrence. Compromised lung function in smokers, in combination with VTE, has often resulted in an increased severity of respiratory complications, requiring more intensive interventions. Regarding the need for surgical intervention, some studies have observed that smokers with VTE, especially those with massive pulmonary embolism, were more likely to require surgical thrombectomies to remove obstructive clots. Conclusion: The relationship between smoking and increased severity of pulmonary complications, as well as the need for surgical intervention, is an important concern in the management of these patients. Early identification and smoking cessation should be emphasized when managing patients with VTE. Furthermore, careful assessment of the risk of VTE in smokers and the implementation of prevention strategies are crucial to reduce clinical complications and the need for surgical intervention. This review highlights the importance of addressing smoking as a significant risk factor in the context of VTE and emphasizes the need for clinical and behavioral interventions to improve clinical outcomes for these patients.