Incidence and risk factors of venous thromboembolism in neurosurgical patients after implementing a screening protocol: a retrospective cohort study of a tertiary center
Issued Date
2024-02-05
Resource Type
ISSN
24058572
Scopus ID
2-s2.0-85200380650
Journal Title
International Journal of Surgery Open
Volume
62
Issue
2
Start Page
109
End Page
115
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Surgery Open Vol.62 No.2 (2024) , 109-115
Suggested Citation
Boongird A., Songkwamcharoen T., Mongkolpech W., Kittitirapong N. Incidence and risk factors of venous thromboembolism in neurosurgical patients after implementing a screening protocol: a retrospective cohort study of a tertiary center. International Journal of Surgery Open Vol.62 No.2 (2024) , 109-115. 115. doi:10.1097/IO9.0000000000000026 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/100426
Title
Incidence and risk factors of venous thromboembolism in neurosurgical patients after implementing a screening protocol: a retrospective cohort study of a tertiary center
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Corresponding Author(s)
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Abstract
Introduction: Venous thromboembolism (VTE) is a common complication in neurosurgical procedures both before and after surgery. Objective: To examine the incidence of VTE in neurosurgical patients before surgery and in the postoperative period after implementing a VTE prophylaxis protocol. The authors also aimed to determine VTE risk factors. Methods: The authors conducted a retrospective cohort study examining 200 patients admitted to the hospital for cranial and spine neurosurgical procedures between January 2020 and October 2021. All patients were screened for VTE using a protocol combining measurement of D-dimer level and venous duplex ultrasonography. Patients who screened negative for VTE were evaluated for VTE risk using the Caprini risk assessment model; those with Caprini score greater than or equal to 3 (indicating moderate-to-high risk) received VTE prophylaxis using intermittent pneumatic compression devices. Results: Preoperative screening demonstrated deep venous thrombosis (DVT) in seven of 200 patients (3.5%). All DVTs were asymptomatic and proximal in location. Univariate logistic regression showed that stroke, neurodegenerative disease, and confinement to bed for more than 72 h were significant predictors of preoperative DVT. Among the patients without DVT on preoperative screening, 179 (93%) had a Caprini score greater than or equal to 3; intermittent pneumatic compression was used for prophylaxis in 173 of these (96.6%). Incidence of postoperative VTE was 2.6% (5/193). Extended length of hospital stay, postoperative hydrocephalus, and infection were significant risk factors for VTE. Conclusion: Preoperative VTE screening using D-dimer level and V-DUS and implementation of VTE prophylaxis using IPC can reduce the incidence of VTE and VTE-related mortality in neurosurgical patients.