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Postoperative Venous Thromboembolism after Neurotologic Surgery
Noor-E-Seher Ali1, Jennifer C Alyono1, Yohan Song1
1Department of Otolaryngology, Stanford University, Stanford, California, United States.
Journal of Neurological Surgery. Part B, Skull Base
|May 24, 2021
Summary
Postoperative venous thromboembolism (VTE) occurred in 1.3% of neurotologic surgery patients. The Caprini risk score effectively predicted VTE risk, suggesting its utility in clinical decision-making for this patient group.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Medical Informatics
Background:
- Venous thromboembolism (VTE) is a significant concern in surgical patients.
- Risk stratification for VTE in neurotologic surgery remains an area needing further investigation.
Purpose of the Study:
- To determine the incidence of postoperative VTE in adults undergoing neurotologic surgery.
- To evaluate the predictive value of the Caprini risk score for VTE in this population.
Main Methods:
- Retrospective review of 387 adult patients undergoing neurotologic surgery (August 2009-December 2016).
- VTE events within 30 postoperative days were identified through diagnosis codes, imaging, and keyword searches.
- Caprini risk scores were calculated for all patients.
Main Results:
- Five postoperative VTE events occurred (1.3% incidence), including 3 pulmonary embolisms and 2 deep vein thromboses.
- Patients with a Caprini score > 8 had a significantly higher VTE rate (12.5%) compared to those with scores < 8 (1%, p=0.004).
- The Caprini risk assessment model demonstrated fair predictive ability for VTE (C-statistic = 0.70).
Conclusions:
- The Caprini score appears to be a useful predictor of VTE risk in patients undergoing neurotologic surgery.
- Balancing the benefits of chemoprophylaxis against risks like bleeding and intracranial hemorrhage is crucial.
- Further research may refine VTE risk stratification for neurotologic surgery patients.
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