Three-Month Incidence of Venous Thromboembolism in Patients Who Underwent Neurological Surgeries

Background/Objectives: The incidences of venous thromboembolism (VTE) in patients undergoing neurological surgeries vary. The objectives were to assess the incidence and risk factors of VTE, bleeding and all-cause mortality in patients undergoing neurological surgery. Methods: This retrospective cohort study was conducted at a single center, a university-based hospital in Thailand. Inclusion criteria comprised patients aged 15 years or older who were admitted for elective or emergency neurosurgery. Patients with preoperative VTE diagnosed within three months or a history of anticoagulant use were excluded. Outcomes measured included the 90-day incidences of VTE, any bleeding, major bleeding, and mortality. Results: Between January 2021 and December 2022, a total of 626 patients were included. The mean age was 50.21 ± 17.37 years, and 55.27% were males. Thromboprophylaxis was administered to 86 patients (13.74%, 95% CI 11.14-16.69). Fourteen patients were confirmed to have symptomatic VTE, resulting in an incidence of 2.24%, with a 95% confidence interval (CI) of 1.23-3.72. Patients aged ≥75 years (HR 4.53; 95% CI 1.25-16.38; p = 0.021), those with cancer (HR 8.51; 95% CI 2.95-24.60, p <0.001), and those experiencing postoperative paraparesis/paralysis (HR 3.26; 95% CI 1.12-9.45; p = 0.030) were associated with an increased risk of postoperative VTE. Fifty-three patients (8.47%, 95% CI 6.41-10.93) experienced any bleeding, with 23 patients (3.67%, 95% CI 2.34-5.46) having major bleeding. The incidence of postoperative mortality was 6.55%, with a 95% CI of 4.74-8.78. Conclusions: This study revealed that elderly patients, those with cancer or those experiencing postoperative paraparesis/paralysis were at higher risk of VTE. These patients were likely to benefit from VTE prophylaxis.