Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.

<h4>Background</h4>Meningiomas are associated with the highest postoperative rate of venous thromboembolic events (VTE) among all intracranial tumors. The aim of this study is to compare two entirely different VTE prophylaxis regimens in 724 consecutive patients undergoing meningioma sur...

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Autores principales:	Christian Valentin Eisenring, Marian Christoph Neidert, Daniel Sabanés Bové, Leonhard Held, Johannes Sarnthein, Niklaus Krayenbühl
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/df41b828b65540adaa682907f5fc84b3
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spelling	oai:doaj.org-article:df41b828b65540adaa682907f5fc84b32021-11-18T08:46:35ZReduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.1932-620310.1371/journal.pone.0079170https://doaj.org/article/df41b828b65540adaa682907f5fc84b32013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24244441/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Meningiomas are associated with the highest postoperative rate of venous thromboembolic events (VTE) among all intracranial tumors. The aim of this study is to compare two entirely different VTE prophylaxis regimens in 724 consecutive patients undergoing meningioma surgery.<h4>Methods</h4>Two cohorts at a single institution treated with different regimens to prevent VTE were reviewed retrospectively. Cohort A (n = 482; 314 females, mean age 57 years, range: 11-87 years) received our institutional regimen during the years 1999-2006, consisting of low-molecular-weight heparin (LMWH) and compression stockings. For cohort B (n = 242; 163 females, mean age 56.8 years, range: 16-90 years), during the years 2008-2010, the management included intraoperative 10°-20° leg elevation with intermittent pneumatic compression (IPC), heparin and LMWH administration. We compared the incidence of the endpoints pulmonary embolism (PE), deep venous thrombosis (DVT), hemorrhage and death, taking into account several known associated risk factors.<h4>Results</h4>For all endpoints, we observed a more favorable outcome with the new regimen. The difference in incidence of PEs (cohort A: 38/482, 8%; cohort B: 6/242, 2.5%) reached statistical significance (p = 0.002). In general, patients with skull base meningiomas had a higher risk for PE (OR 2.77). Regarding VTE prophylaxis, an adjusted subgroup analysis suggests that the new regimen is particularly beneficial for patients with skull base meningiomas.<h4>Conclusions</h4>We recommend perioperative prophylaxis using a management composed of intraoperative leg-elevation, IPC, early heparin administration and LMWH to reduce the risk for PE.Christian Valentin EisenringMarian Christoph NeidertDaniel Sabanés BovéLeonhard HeldJohannes SarntheinNiklaus KrayenbühlPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e79170 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Christian Valentin Eisenring Marian Christoph Neidert Daniel Sabanés Bové Leonhard Held Johannes Sarnthein Niklaus Krayenbühl Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.
description	<h4>Background</h4>Meningiomas are associated with the highest postoperative rate of venous thromboembolic events (VTE) among all intracranial tumors. The aim of this study is to compare two entirely different VTE prophylaxis regimens in 724 consecutive patients undergoing meningioma surgery.<h4>Methods</h4>Two cohorts at a single institution treated with different regimens to prevent VTE were reviewed retrospectively. Cohort A (n = 482; 314 females, mean age 57 years, range: 11-87 years) received our institutional regimen during the years 1999-2006, consisting of low-molecular-weight heparin (LMWH) and compression stockings. For cohort B (n = 242; 163 females, mean age 56.8 years, range: 16-90 years), during the years 2008-2010, the management included intraoperative 10°-20° leg elevation with intermittent pneumatic compression (IPC), heparin and LMWH administration. We compared the incidence of the endpoints pulmonary embolism (PE), deep venous thrombosis (DVT), hemorrhage and death, taking into account several known associated risk factors.<h4>Results</h4>For all endpoints, we observed a more favorable outcome with the new regimen. The difference in incidence of PEs (cohort A: 38/482, 8%; cohort B: 6/242, 2.5%) reached statistical significance (p = 0.002). In general, patients with skull base meningiomas had a higher risk for PE (OR 2.77). Regarding VTE prophylaxis, an adjusted subgroup analysis suggests that the new regimen is particularly beneficial for patients with skull base meningiomas.<h4>Conclusions</h4>We recommend perioperative prophylaxis using a management composed of intraoperative leg-elevation, IPC, early heparin administration and LMWH to reduce the risk for PE.
format	article
author	Christian Valentin Eisenring Marian Christoph Neidert Daniel Sabanés Bové Leonhard Held Johannes Sarnthein Niklaus Krayenbühl
author_facet	Christian Valentin Eisenring Marian Christoph Neidert Daniel Sabanés Bové Leonhard Held Johannes Sarnthein Niklaus Krayenbühl
author_sort	Christian Valentin Eisenring
title	Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.
title_short	Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.
title_full	Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.
title_fullStr	Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.
title_full_unstemmed	Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.
title_sort	reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/df41b828b65540adaa682907f5fc84b3
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Reduction of thromboembolic events in meningioma surgery: a cohort study of 724 consecutive patients.

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