Development of venous thromboembolism (VTE) in patients undergoing surgery for brain tumors

Results from a single center over a 10 year period

Timothy R. Smith, Allan D. Nanney, Rishi Rajiv Lall, Randall B. Graham, Jamal McClendon, Rohan R. Lall, Joseph G. Adel, Anaadriana Zakarija, David J. Cote, James P. Chandler

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Patients who undergo craniotomy for brain neoplasms have a high risk of developing venous thromboembolism (VTE), including deep vein thromboses (DVT) and pulmonary emboli (PE). The reasons for this correlation are not fully understood. This retrospective, single-center review aimed to determine the risk factors for VTE in patients who underwent neurosurgical resection of brain tumors at Northwestern University from 1999 to 2010. Our cohort included 1148 patients, 158 (13.7%) of whom were diagnosed with DVT and 38 (3.3%) of whom were diagnosed with PE. A variety of clinical factors were studied to determine predictors of VTE, including sex, ethnicity, medical co-morbidities, surgical positioning, length of hospital stay, tumor location, and tumor histology. Use of post-operative anticoagulants and hemorrhagic complications were also investigated. A prior history of VTE was found to be highly predictive of post-operative DVT (odds ratio [OR] = 7.6, p = 0.01), as was the patient's sex (OR = 14.2, p < 0.001), ethnicity (OR = 0.5, p = 0.04), post-operative intensive care unit days (OR = 0.2, p = 0.003), and tumor histology (OR = -0.16, p = 0.01). Contrary to reports in the literature, the data collected did not indicate that the administration of post-operative medical prophylaxis for VTE was significant in preventing their formation (OR = -0.14, p = 0.76). Hemorrhagic complications were low (2.2%) and resultant neurologic deficit was lower still (0.7%). The study indicates that patients with high-grade primary brain tumors and metastatic lesions should receive aggressive preventative measures in the post-operative period.

Original languageEnglish (US)
Pages (from-to)519-525
Number of pages7
JournalJournal of Clinical Neuroscience
Volume22
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

Fingerprint

Venous Thromboembolism
Brain Neoplasms
Odds Ratio
Venous Thrombosis
Embolism
Length of Stay
Histology
Neoplasms
Lung
Craniotomy
Sex Ratio
Neurologic Manifestations
Anticoagulants
Intensive Care Units
Morbidity

Keywords

  • Brain tumor
  • Deep vein thrombosis
  • Neurosurgery
  • Pulmonary embolism
  • Venous thromboembolism

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Development of venous thromboembolism (VTE) in patients undergoing surgery for brain tumors : Results from a single center over a 10 year period. / Smith, Timothy R.; Nanney, Allan D.; Lall, Rishi Rajiv; Graham, Randall B.; McClendon, Jamal; Lall, Rohan R.; Adel, Joseph G.; Zakarija, Anaadriana; Cote, David J.; Chandler, James P.

In: Journal of Clinical Neuroscience, Vol. 22, No. 3, 01.03.2015, p. 519-525.

Research output: Contribution to journalArticle

Smith, Timothy R. ; Nanney, Allan D. ; Lall, Rishi Rajiv ; Graham, Randall B. ; McClendon, Jamal ; Lall, Rohan R. ; Adel, Joseph G. ; Zakarija, Anaadriana ; Cote, David J. ; Chandler, James P. / Development of venous thromboembolism (VTE) in patients undergoing surgery for brain tumors : Results from a single center over a 10 year period. In: Journal of Clinical Neuroscience. 2015 ; Vol. 22, No. 3. pp. 519-525.
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abstract = "Patients who undergo craniotomy for brain neoplasms have a high risk of developing venous thromboembolism (VTE), including deep vein thromboses (DVT) and pulmonary emboli (PE). The reasons for this correlation are not fully understood. This retrospective, single-center review aimed to determine the risk factors for VTE in patients who underwent neurosurgical resection of brain tumors at Northwestern University from 1999 to 2010. Our cohort included 1148 patients, 158 (13.7{\%}) of whom were diagnosed with DVT and 38 (3.3{\%}) of whom were diagnosed with PE. A variety of clinical factors were studied to determine predictors of VTE, including sex, ethnicity, medical co-morbidities, surgical positioning, length of hospital stay, tumor location, and tumor histology. Use of post-operative anticoagulants and hemorrhagic complications were also investigated. A prior history of VTE was found to be highly predictive of post-operative DVT (odds ratio [OR] = 7.6, p = 0.01), as was the patient's sex (OR = 14.2, p < 0.001), ethnicity (OR = 0.5, p = 0.04), post-operative intensive care unit days (OR = 0.2, p = 0.003), and tumor histology (OR = -0.16, p = 0.01). Contrary to reports in the literature, the data collected did not indicate that the administration of post-operative medical prophylaxis for VTE was significant in preventing their formation (OR = -0.14, p = 0.76). Hemorrhagic complications were low (2.2{\%}) and resultant neurologic deficit was lower still (0.7{\%}). The study indicates that patients with high-grade primary brain tumors and metastatic lesions should receive aggressive preventative measures in the post-operative period.",
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