Venous thromboembolism chemical prophylaxis after skull base surgery
Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients tr...
Ausführliche Beschreibung
Autor*in: |
Waqar, Mueez [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2024 |
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Schlagwörter: |
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Anmerkung: |
© Crown 2024 |
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Übergeordnetes Werk: |
Enthalten in: Acta neurochirurgica - Springer Vienna, 1950, 166(2024), 1 vom: 03. Apr. |
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Übergeordnetes Werk: |
volume:166 ; year:2024 ; number:1 ; day:03 ; month:04 |
Links: |
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DOI / URN: |
10.1007/s00701-024-06035-9 |
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Katalog-ID: |
SPR055379001 |
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520 | |a Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. | ||
650 | 4 | |a Venous thromboembolism |7 (dpeaa)DE-He213 | |
650 | 4 | |a Skull base |7 (dpeaa)DE-He213 | |
650 | 4 | |a Deep vein thrombosis |7 (dpeaa)DE-He213 | |
650 | 4 | |a Pulmonary embolism |7 (dpeaa)DE-He213 | |
650 | 4 | |a Cranial base |7 (dpeaa)DE-He213 | |
650 | 4 | |a Vestibular schwannoma |7 (dpeaa)DE-He213 | |
650 | 4 | |a Neurosurgery |7 (dpeaa)DE-He213 | |
650 | 4 | |a Otolaryngology |7 (dpeaa)DE-He213 | |
650 | 4 | |a Hematoma |7 (dpeaa)DE-He213 | |
700 | 1 | |a Yaseen, Omar |4 aut | |
700 | 1 | |a Chadwick, Annabel |4 aut | |
700 | 1 | |a Lee, Jing Xian |4 aut | |
700 | 1 | |a Khan, Ghazn |4 aut | |
700 | 1 | |a Evans, D. Gareth |4 aut | |
700 | 1 | |a Horner, Daniel |4 aut | |
700 | 1 | |a Jaiswal, Archana |4 aut | |
700 | 1 | |a Freeman, Simon |4 aut | |
700 | 1 | |a Bhalla, Rajiv |4 aut | |
700 | 1 | |a Lloyd, Simon |4 aut | |
700 | 1 | |a Hammerbeck-Ward, Charlotte |4 aut | |
700 | 1 | |a Rutherford, Scott A. |4 aut | |
700 | 1 | |a King, Andrew T. |4 aut | |
700 | 1 | |a Pathmanaban, Omar N. |4 aut | |
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10.1007/s00701-024-06035-9 doi (DE-627)SPR055379001 (SPR)s00701-024-06035-9-e DE-627 ger DE-627 rakwb eng 610 VZ 44.65 bkl 44.90 bkl Waqar, Mueez verfasserin (orcid)0000-0002-7848-6237 aut Venous thromboembolism chemical prophylaxis after skull base surgery 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Crown 2024 Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. Venous thromboembolism (dpeaa)DE-He213 Skull base (dpeaa)DE-He213 Deep vein thrombosis (dpeaa)DE-He213 Pulmonary embolism (dpeaa)DE-He213 Cranial base (dpeaa)DE-He213 Vestibular schwannoma (dpeaa)DE-He213 Neurosurgery (dpeaa)DE-He213 Otolaryngology (dpeaa)DE-He213 Hematoma (dpeaa)DE-He213 Yaseen, Omar aut Chadwick, Annabel aut Lee, Jing Xian aut Khan, Ghazn aut Evans, D. Gareth aut Horner, Daniel aut Jaiswal, Archana aut Freeman, Simon aut Bhalla, Rajiv aut Lloyd, Simon aut Hammerbeck-Ward, Charlotte aut Rutherford, Scott A. aut King, Andrew T. aut Pathmanaban, Omar N. aut Enthalten in Acta neurochirurgica Springer Vienna, 1950 166(2024), 1 vom: 03. Apr. (DE-627)265508398 (DE-600)1464215-3 0942-0940 nnns volume:166 year:2024 number:1 day:03 month:04 https://dx.doi.org/10.1007/s00701-024-06035-9 kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 VZ 44.90 VZ AR 166 2024 1 03 04 |
spelling |
10.1007/s00701-024-06035-9 doi (DE-627)SPR055379001 (SPR)s00701-024-06035-9-e DE-627 ger DE-627 rakwb eng 610 VZ 44.65 bkl 44.90 bkl Waqar, Mueez verfasserin (orcid)0000-0002-7848-6237 aut Venous thromboembolism chemical prophylaxis after skull base surgery 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Crown 2024 Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. Venous thromboembolism (dpeaa)DE-He213 Skull base (dpeaa)DE-He213 Deep vein thrombosis (dpeaa)DE-He213 Pulmonary embolism (dpeaa)DE-He213 Cranial base (dpeaa)DE-He213 Vestibular schwannoma (dpeaa)DE-He213 Neurosurgery (dpeaa)DE-He213 Otolaryngology (dpeaa)DE-He213 Hematoma (dpeaa)DE-He213 Yaseen, Omar aut Chadwick, Annabel aut Lee, Jing Xian aut Khan, Ghazn aut Evans, D. Gareth aut Horner, Daniel aut Jaiswal, Archana aut Freeman, Simon aut Bhalla, Rajiv aut Lloyd, Simon aut Hammerbeck-Ward, Charlotte aut Rutherford, Scott A. aut King, Andrew T. aut Pathmanaban, Omar N. aut Enthalten in Acta neurochirurgica Springer Vienna, 1950 166(2024), 1 vom: 03. Apr. (DE-627)265508398 (DE-600)1464215-3 0942-0940 nnns volume:166 year:2024 number:1 day:03 month:04 https://dx.doi.org/10.1007/s00701-024-06035-9 kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 VZ 44.90 VZ AR 166 2024 1 03 04 |
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10.1007/s00701-024-06035-9 doi (DE-627)SPR055379001 (SPR)s00701-024-06035-9-e DE-627 ger DE-627 rakwb eng 610 VZ 44.65 bkl 44.90 bkl Waqar, Mueez verfasserin (orcid)0000-0002-7848-6237 aut Venous thromboembolism chemical prophylaxis after skull base surgery 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Crown 2024 Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. Venous thromboembolism (dpeaa)DE-He213 Skull base (dpeaa)DE-He213 Deep vein thrombosis (dpeaa)DE-He213 Pulmonary embolism (dpeaa)DE-He213 Cranial base (dpeaa)DE-He213 Vestibular schwannoma (dpeaa)DE-He213 Neurosurgery (dpeaa)DE-He213 Otolaryngology (dpeaa)DE-He213 Hematoma (dpeaa)DE-He213 Yaseen, Omar aut Chadwick, Annabel aut Lee, Jing Xian aut Khan, Ghazn aut Evans, D. Gareth aut Horner, Daniel aut Jaiswal, Archana aut Freeman, Simon aut Bhalla, Rajiv aut Lloyd, Simon aut Hammerbeck-Ward, Charlotte aut Rutherford, Scott A. aut King, Andrew T. aut Pathmanaban, Omar N. aut Enthalten in Acta neurochirurgica Springer Vienna, 1950 166(2024), 1 vom: 03. Apr. (DE-627)265508398 (DE-600)1464215-3 0942-0940 nnns volume:166 year:2024 number:1 day:03 month:04 https://dx.doi.org/10.1007/s00701-024-06035-9 kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 VZ 44.90 VZ AR 166 2024 1 03 04 |
allfieldsGer |
10.1007/s00701-024-06035-9 doi (DE-627)SPR055379001 (SPR)s00701-024-06035-9-e DE-627 ger DE-627 rakwb eng 610 VZ 44.65 bkl 44.90 bkl Waqar, Mueez verfasserin (orcid)0000-0002-7848-6237 aut Venous thromboembolism chemical prophylaxis after skull base surgery 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Crown 2024 Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. Venous thromboembolism (dpeaa)DE-He213 Skull base (dpeaa)DE-He213 Deep vein thrombosis (dpeaa)DE-He213 Pulmonary embolism (dpeaa)DE-He213 Cranial base (dpeaa)DE-He213 Vestibular schwannoma (dpeaa)DE-He213 Neurosurgery (dpeaa)DE-He213 Otolaryngology (dpeaa)DE-He213 Hematoma (dpeaa)DE-He213 Yaseen, Omar aut Chadwick, Annabel aut Lee, Jing Xian aut Khan, Ghazn aut Evans, D. Gareth aut Horner, Daniel aut Jaiswal, Archana aut Freeman, Simon aut Bhalla, Rajiv aut Lloyd, Simon aut Hammerbeck-Ward, Charlotte aut Rutherford, Scott A. aut King, Andrew T. aut Pathmanaban, Omar N. aut Enthalten in Acta neurochirurgica Springer Vienna, 1950 166(2024), 1 vom: 03. Apr. (DE-627)265508398 (DE-600)1464215-3 0942-0940 nnns volume:166 year:2024 number:1 day:03 month:04 https://dx.doi.org/10.1007/s00701-024-06035-9 kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 VZ 44.90 VZ AR 166 2024 1 03 04 |
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10.1007/s00701-024-06035-9 doi (DE-627)SPR055379001 (SPR)s00701-024-06035-9-e DE-627 ger DE-627 rakwb eng 610 VZ 44.65 bkl 44.90 bkl Waqar, Mueez verfasserin (orcid)0000-0002-7848-6237 aut Venous thromboembolism chemical prophylaxis after skull base surgery 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Crown 2024 Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. Venous thromboembolism (dpeaa)DE-He213 Skull base (dpeaa)DE-He213 Deep vein thrombosis (dpeaa)DE-He213 Pulmonary embolism (dpeaa)DE-He213 Cranial base (dpeaa)DE-He213 Vestibular schwannoma (dpeaa)DE-He213 Neurosurgery (dpeaa)DE-He213 Otolaryngology (dpeaa)DE-He213 Hematoma (dpeaa)DE-He213 Yaseen, Omar aut Chadwick, Annabel aut Lee, Jing Xian aut Khan, Ghazn aut Evans, D. Gareth aut Horner, Daniel aut Jaiswal, Archana aut Freeman, Simon aut Bhalla, Rajiv aut Lloyd, Simon aut Hammerbeck-Ward, Charlotte aut Rutherford, Scott A. aut King, Andrew T. aut Pathmanaban, Omar N. aut Enthalten in Acta neurochirurgica Springer Vienna, 1950 166(2024), 1 vom: 03. Apr. (DE-627)265508398 (DE-600)1464215-3 0942-0940 nnns volume:166 year:2024 number:1 day:03 month:04 https://dx.doi.org/10.1007/s00701-024-06035-9 kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_266 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 VZ 44.90 VZ AR 166 2024 1 03 04 |
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Enthalten in Acta neurochirurgica 166(2024), 1 vom: 03. Apr. volume:166 year:2024 number:1 day:03 month:04 |
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Enthalten in Acta neurochirurgica 166(2024), 1 vom: 03. Apr. volume:166 year:2024 number:1 day:03 month:04 |
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Venous thromboembolism Skull base Deep vein thrombosis Pulmonary embolism Cranial base Vestibular schwannoma Neurosurgery Otolaryngology Hematoma |
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Waqar, Mueez @@aut@@ Yaseen, Omar @@aut@@ Chadwick, Annabel @@aut@@ Lee, Jing Xian @@aut@@ Khan, Ghazn @@aut@@ Evans, D. Gareth @@aut@@ Horner, Daniel @@aut@@ Jaiswal, Archana @@aut@@ Freeman, Simon @@aut@@ Bhalla, Rajiv @@aut@@ Lloyd, Simon @@aut@@ Hammerbeck-Ward, Charlotte @@aut@@ Rutherford, Scott A. @@aut@@ King, Andrew T. @@aut@@ Pathmanaban, Omar N. @@aut@@ |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">SPR055379001</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20240403064651.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">240403s2024 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s00701-024-06035-9</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR055379001</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s00701-024-06035-9-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">VZ</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.65</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.90</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Waqar, Mueez</subfield><subfield code="e">verfasserin</subfield><subfield code="0">(orcid)0000-0002-7848-6237</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Venous thromboembolism chemical prophylaxis after skull base surgery</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2024</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© Crown 2024</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. 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|
author |
Waqar, Mueez |
spellingShingle |
Waqar, Mueez ddc 610 bkl 44.65 bkl 44.90 misc Venous thromboembolism misc Skull base misc Deep vein thrombosis misc Pulmonary embolism misc Cranial base misc Vestibular schwannoma misc Neurosurgery misc Otolaryngology misc Hematoma Venous thromboembolism chemical prophylaxis after skull base surgery |
authorStr |
Waqar, Mueez |
ppnlink_with_tag_str_mv |
@@773@@(DE-627)265508398 |
format |
electronic Article |
dewey-ones |
610 - Medicine & health |
delete_txt_mv |
keep |
author_role |
aut aut aut aut aut aut aut aut aut aut aut aut aut aut aut |
collection |
springer |
remote_str |
true |
illustrated |
Not Illustrated |
issn |
0942-0940 |
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610 VZ 44.65 bkl 44.90 bkl Venous thromboembolism chemical prophylaxis after skull base surgery Venous thromboembolism (dpeaa)DE-He213 Skull base (dpeaa)DE-He213 Deep vein thrombosis (dpeaa)DE-He213 Pulmonary embolism (dpeaa)DE-He213 Cranial base (dpeaa)DE-He213 Vestibular schwannoma (dpeaa)DE-He213 Neurosurgery (dpeaa)DE-He213 Otolaryngology (dpeaa)DE-He213 Hematoma (dpeaa)DE-He213 |
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ddc 610 bkl 44.65 bkl 44.90 misc Venous thromboembolism misc Skull base misc Deep vein thrombosis misc Pulmonary embolism misc Cranial base misc Vestibular schwannoma misc Neurosurgery misc Otolaryngology misc Hematoma |
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ddc 610 bkl 44.65 bkl 44.90 misc Venous thromboembolism misc Skull base misc Deep vein thrombosis misc Pulmonary embolism misc Cranial base misc Vestibular schwannoma misc Neurosurgery misc Otolaryngology misc Hematoma |
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ddc 610 bkl 44.65 bkl 44.90 misc Venous thromboembolism misc Skull base misc Deep vein thrombosis misc Pulmonary embolism misc Cranial base misc Vestibular schwannoma misc Neurosurgery misc Otolaryngology misc Hematoma |
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Venous thromboembolism chemical prophylaxis after skull base surgery |
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Waqar, Mueez Yaseen, Omar Chadwick, Annabel Lee, Jing Xian Khan, Ghazn Evans, D. Gareth Horner, Daniel Jaiswal, Archana Freeman, Simon Bhalla, Rajiv Lloyd, Simon Hammerbeck-Ward, Charlotte Rutherford, Scott A. King, Andrew T. Pathmanaban, Omar N. |
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venous thromboembolism chemical prophylaxis after skull base surgery |
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Venous thromboembolism chemical prophylaxis after skull base surgery |
abstract |
Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. © Crown 2024 |
abstractGer |
Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. © Crown 2024 |
abstract_unstemmed |
Purpose There is no guidance surrounding postoperative venous thromboembolism (VTE) prophylaxis using pharmacological agents (chemoprophylaxis) in patients undergoing skull base surgery. The aim of this study was to compare VTE and intracranial haematoma rates after skull base surgery in patients treated with/without chemoprophylaxis. Methods Review of prospective quaternary centre database including adults undergoing first-time skull base surgery (2009–2020). VTE was defined as deep vein thrombosis (DVT) and pulmonary embolism (PE) within 6 months of surgery. Multivariate logistic regression was used to determine factors predictive of postoperative intracranial haematoma/VTE. Propensity score matching (PSM) was used in group comparisons. Results One thousand five hundred fifty-one patients were included with a median age of 52 years (range 16–89 years) and female predominance (62%). Postoperative chemoprophylaxis was used in 81% of patients at a median of 1 day postoperatively. There were 12 VTE events (1.2%), and the use of chemoprophylaxis did not negate the risk of VTE entirely (p > 0.99) and was highest on/after postoperative day 6 (9/12 VTE events). There were 18 intracranial haematomas (0.8%), and after PSM, chemoprophylaxis did not significantly increase the risk of an intracranial haematoma (p > 0.99). Patients administered chemoprophylaxis from postoperative days 1 and 2 had similar rates of intracranial haematomas (p = 0.60) and VTE (p = 0.60), affirmed in PSM. Conclusion Postoperative chemoprophylaxis represents a relatively safe strategy in patients undergoing skull base surgery. We advocate a personalised approach to chemoprophylaxis and recommend it on postoperative days 1 or 2 when indicated. © Crown 2024 |
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Yaseen, Omar Chadwick, Annabel Lee, Jing Xian Khan, Ghazn Evans, D. Gareth Horner, Daniel Jaiswal, Archana Freeman, Simon Bhalla, Rajiv Lloyd, Simon Hammerbeck-Ward, Charlotte Rutherford, Scott A. King, Andrew T. Pathmanaban, Omar N. |
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|
score |
7.399722 |