Hemostasis activation in patients undergoing brain tumor surgery

Area of Science:

• Neurosurgery
• Hematology
• Oncology

Background:

• Patients undergoing brain tumor surgery face a significant risk of thromboembolic events.
• Routine coagulation parameters often show changes due to hemodilution and acute-phase reactions during major surgery.
• D-dimer, a specific hemostasis activation marker, warrants investigation for risk stratification.

Purpose of the Study:

• To identify a reliable laboratory marker for estimating thromboembolic risk in patients undergoing brain tumor surgery.
• To analyze the perioperative time pattern of D-dimer and routine coagulation parameters in different risk groups.

Main Methods:

• Prospective study of 28 patients undergoing brain tumor surgery, categorized by thromboembolic risk (high-risk: glioma, meningioma; low-risk: metastases).
• Perioperative monitoring of routine coagulation parameters and D-dimer levels.
• Comparison of marker levels between high-risk and low-risk groups at baseline, during surgery, and postoperatively (Days 2 and 7).

Main Results:

• Routine coagulation parameters showed typical perioperative changes but did not differentiate risk groups.
• D-dimer levels were elevated preoperatively in metastasis patients, indicating baseline hemostatic hyperactivity.
• Marked perioperative increases in D-dimer were observed in glioma and meningioma patients, with sustained elevation postoperatively, unlike metastasis patients.

Conclusions:

• Perioperative D-dimer levels correlate with the high thromboembolic risk associated with meningioma and glioma.
• D-dimer shows promise as a marker for estimating individual thromboembolic risk in brain tumor surgery patients.
• Further evaluation of D-dimer is recommended for assessing prophylactic treatment efficacy.