[Prevention of postoperative thromboembolic complications in patients with brain tumors]

Venous thromboembolic complications (VTE) represent a serious problem for neurosurgical patients, especially after brain tumor resection surgeries. Due to the specific nature of neurosurgical diseases, the risk of these complications significantly increases.

This study aimed to assess the effectiveness of implementing a systematic approach to VTE prophylaxis in patients undergoing brain tumor resection, using risk stratification algorithms and early administration of low molecular weight heparin.

The study was conducted at the Federal Center of Neurosurgery in Novosibirsk, using a retrospective analysis of data from 3486 brain tumor resection surgeries. By means of propensity score matching, the patients were divided into two groups: the control group (1002 patients who underwent surgery before the implementation of the new prophylactic algorithm) and the study group (1002 patients who underwent surgery with the application of a systematic approach to VTE prophylaxis). The results of VTE risk stratification, early administration of low molecular weight heparin, and their association with the frequency of complications were evaluated.

The obtained findings showed that the application of the new prophylactic algorithm significantly reduced the incidence of clinically significant pulmonary embolism to 0.2 vs 0.6% in the control group. No fatalities from pulmonary embolism were recorded in the study group. However, there was a slight increase in cases of intracranial hemorrhage (1.8 vs 1.3%).

Preoperative risk stratification for VTE and early administration of prophylactic doses of low molecular weight heparin can reduce the frequency of thromboembolic events with comparable risks of intracranial hemorrhage.