TY - JOUR
T1 - Deep venous thrombosis and pulmonary embolisms in adult patients undergoing craniotomy for brain tumors
AU - Chaichana, Kaisorn L.
AU - Pendleton, Courtney
AU - Jackson, Christopher
AU - Martinez-Gutierrez, Juan Carlos
AU - Diaz-Stransky, Andrea
AU - Aguayo, Javier
AU - Olivi, Alessandro
AU - Weingart, Jon
AU - Gallia, Gary
AU - Lim, Michael
AU - Brem, Henry
AU - Quinones-Hinojosa, Alfredo
PY - 2013/3
Y1 - 2013/3
N2 - Objective: The development of venothromboembolisms (VTEs), including deep vein thrombosis (DVT) and pulmonary emboli (PE), is common in brain tumor patients. Their development can be catastrophic. Studies evaluating pre-operative clinical factors that predispose patients to the development of VTE are few and limited. An understanding may help risk stratify patients and guide subsequent therapy aimed at reducing the risk of DVTs/PEs. Methods: All adult patients who underwent surgery for an intracranial tumor at an academic tertiary care institution between 1998 and 2008 were retrospectively reviewed. Stepwise multivariate logistical regression analysis was used to identify pre-operative factors associated with the development of peri-operative (within 30 days of surgery) DVTs/PEs among patients who underwent surgery of their intracranial tumor. Results: Of the 4293 patients in this study, 126 (3%) patients developed DVT and/or PE in the peri-operative period. The pre-operative factors independently associated with the development of DVTs/PEs were: poorer Karnofsky performance scale (KPS) [odds ratio (OR), 1.040; 95% confidence interval (CI), 1.026-1.052; P<0.0001], high grade glioma (OR, 1.702; 95% CI, 1.176-2.465; P50.005), older age (OR, 1.033; 95% CI, 1.020- 1.046; P<0.0001), hypertension (OR, 1.785; 95% CI, 1.180-2.699; P50.006), and motor deficit (OR, 1.854; 95% CI, 1.244-2.763; P50.002). Eighty six per cent of the patients with DVTs/PEs were treated with either unfractionated or low molecular weight heparin, and 4% of these patients developed intracranial hemorrhage. Discussion: The present study found that poorer functional status, older age, pre-operative motor deficit, high grade glioma, and hypertension each independently increased the risk of developing peri-operative DVTs/PEs. These findings may provide patients and physicians with prognostic information that may guide therapies aimed at minimizing the development of peri-operative DVTs/PEs.
AB - Objective: The development of venothromboembolisms (VTEs), including deep vein thrombosis (DVT) and pulmonary emboli (PE), is common in brain tumor patients. Their development can be catastrophic. Studies evaluating pre-operative clinical factors that predispose patients to the development of VTE are few and limited. An understanding may help risk stratify patients and guide subsequent therapy aimed at reducing the risk of DVTs/PEs. Methods: All adult patients who underwent surgery for an intracranial tumor at an academic tertiary care institution between 1998 and 2008 were retrospectively reviewed. Stepwise multivariate logistical regression analysis was used to identify pre-operative factors associated with the development of peri-operative (within 30 days of surgery) DVTs/PEs among patients who underwent surgery of their intracranial tumor. Results: Of the 4293 patients in this study, 126 (3%) patients developed DVT and/or PE in the peri-operative period. The pre-operative factors independently associated with the development of DVTs/PEs were: poorer Karnofsky performance scale (KPS) [odds ratio (OR), 1.040; 95% confidence interval (CI), 1.026-1.052; P<0.0001], high grade glioma (OR, 1.702; 95% CI, 1.176-2.465; P50.005), older age (OR, 1.033; 95% CI, 1.020- 1.046; P<0.0001), hypertension (OR, 1.785; 95% CI, 1.180-2.699; P50.006), and motor deficit (OR, 1.854; 95% CI, 1.244-2.763; P50.002). Eighty six per cent of the patients with DVTs/PEs were treated with either unfractionated or low molecular weight heparin, and 4% of these patients developed intracranial hemorrhage. Discussion: The present study found that poorer functional status, older age, pre-operative motor deficit, high grade glioma, and hypertension each independently increased the risk of developing peri-operative DVTs/PEs. These findings may provide patients and physicians with prognostic information that may guide therapies aimed at minimizing the development of peri-operative DVTs/PEs.
KW - Brain tumor
KW - Deep vein thrombosis
KW - Glioma
KW - Heparin
KW - Pulmonary embolism
KW - Venothromboembolism
UR - http://www.scopus.com/inward/record.url?scp=84874640473&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874640473&partnerID=8YFLogxK
U2 - 10.1179/1743132812Y.0000000126
DO - 10.1179/1743132812Y.0000000126
M3 - Article
C2 - 23336127
AN - SCOPUS:84874640473
SN - 0161-6412
VL - 35
SP - 206
EP - 211
JO - Neurological Research
JF - Neurological Research
IS - 2
ER -