SURGERY, PSYCHOLOGICAL FACTORS, BLOOD CLOTTING FACTORS IN WOMEN GYN PROCEDURES

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Background: Women with ovarian cancer, the most deadly cancer of the reproductive tract, are at a heightened risk for developing a venous thromboembolism (VTE) after surgical debulking, the primary treatment for virtually all patients. The experience of such a VTE event can result in significant morbidity and sudden death, yet remains largely unpredictable. Evidence from the experimental psychobiology literature has demonstrated effects of psychological stress on coagulation factors, but the implications of this emerging research has yet to be determined in surgery patients. Given the high levels of distress reported in ovarian cancer patients prior to surgery, it is important to determine the role distress may have on coagulation factors that increase risk of VTE. Objective/hypothesis: The purpose of the proposed research is to prospectively assess the effect of preoperative psychological distress on postoperative coagulation factors. It is hypothesized that both higher levels of emotional distress immediately prior to surgery (e.g., emotional upset) as well as background psychological variables (e.g., coping style) will predict heightened coagulation responses to surgery (i.e., increased blood levels of D-Dimer, fibrinogen, PAI-1), controlling for demographic and medical variables. It is further hypothesized that while negative psychological variables may enhance to coagulation response to surgery, positive psychological variables may attenuate it. The study will also statistically explore possible unique and combined effects of state, trait and background psychological variables on postoperative blood levels of thrombosis risk factors.