Preoperative and intraoperative predictors of deep venous thrombosis in adult patients undergoing craniotomy for brain tumors: A Chinese single-center, retrospective study

被引:20
作者
Shi, Shuhai [1 ]
Cheng, Jingli [2 ]
Chen, Haoliang [3 ]
Zhang, Yunxin [1 ]
Zhao, Ying [1 ]
Wang, Baoguo [4 ]
机构
[1] Capital Med Univ, Sanbo Brain Hosp, Dept Crit Care Med, Beijing 100093, Peoples R China
[2] Baotou Med Coll, Dept Neurosurg, Affiliated Hosp 1, Baotou 014010, Inner Mongolia, Peoples R China
[3] Capital Med Univ, Sanbo Brain Hosp, Dept Med Informat, Beijing 100093, Peoples R China
[4] Capital Med Univ, Sanbo Brain Hosp, Dept Anesthesiol, 50 Xiang Shan Yi Ke Song, Beijing 100093, Peoples R China
基金
国家重点研发计划;
关键词
Brain tumor; Preoperative predictors; Deep vein thrombosis; Pulmonary embolism; Neurosurgery; VEIN THROMBOSIS; THROMBOEMBOLISM; RISK; CLASSIFICATION; HEMOSTASIS; PREVENTION; DIAGNOSIS; RESECTION; GLIOMA;
D O I
10.1016/j.thromres.2020.09.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Brain tumor resection by craniotomy is associated with a high risk of deep vein thrombosis (DVT). This study evaluated the incidence and preoperative and intraoperative risk factors for DVT within 30 days of surgery. Methods: The analysis included: 1) basic clinical variables (patient age, sex, body mass index [BMI], tumor location, and tumor histology); 2) blood test results before operation, such as leukocytes, platelets, and coagulation parameters; and 3) surgical factors (total amount of blood lost, anesthesia mode, and surgery duration). Results: Of the 1670 patients, 206 (12.34%) had DVT and nine (0.54%) had both DVT and pulmonary embolism (PE) after surgery. Preoperative and intraoperative factors independently associated with DVT/PE were: older age 46-55 years (odds ratio [OR]: 2.87; 95% confidence interval [CI]: 1.83-4.50; P < 0.001), age 56-65 years (OR: 5.24; 95% CI: 3.27-8.40; P < 0.001), age > 65 years (OR: 6.00; 95% CI: 3.45-10.45; P < 0.001), BMI (OR: 1.03; 95% CI: 1.00-1.05; P = 0.029), activated partial thromboplastin time [APTT] (OR: 0.91; 95% CI: 0.86-0.95; P = 0.000), D-dimer (OR: 1.69; 95% CI: 1.23-2.34; P = 0.001), high-grade glioma (OR: 2.09; 95% CI: 1.28-3.40; P = 0.003), glio-neuronal (OR: 3.30; 95% CI: 1.28-8.47; P = 0.013), craniopharyngioma (OR: 2.16; 95% CI: 1.13-4.10; P = 0.019), and surgery duration (OR: 1.82; 95% CI: 1.27-2.60; P = 0.001). Conclusions: Older age, BMI, preoperative APTT, D-dimer, tumor histology, and surgery duration independently increased the risk of developing postoperative DVT/PE. These findings provide prognostic information that will guide therapies aimed at minimizing the development of DVT/PE during hospitalization.
引用
收藏
页码:245 / 250
页数:6
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