title: Venous thromboembolism occurs infrequently in meningioma patients receiving combined modality prophylaxis.
abstract: BACKGROUND
  Individuals with brain tumors have an increased risk of venous thromboembolism (VTE). Within this population, patients with meningiomas have been reported to have the highest incidence, exceeding rates associated with gliomas and brain metastases. However, earlier studies did not employ VTE prophylaxis, and VTE were detected with radionuclide scans, the reliability of which has since been questioned. Therefore, we conducted a retrospective review of postoperative meningioma patients receiving contemporary VTE prophylaxis and diagnostic methods to define the current incidence of and risk factors for symptomatic VTE in this population.
  
  
  METHODS
  Medical records were reviewed from all patients undergoing craniotomy for meningioma at Johns Hopkins Hospital in 2004 and 2005. The association between clinical characteristics and VTE was assessed using parametric and nonparametric statistical tests and survival analysis.
  
  
  RESULTS
  A total of 224 individuals met criteria for the review. The mean age was 52 years (standard deviation [SD] 14 years), and 167 patients (75%) were women. Median follow-up time was 230 days (interquartile range [IQR], 89-428 days). VTE was diagnosed in 11 patients (4.9%; 95% confidence interval, 2.5%-8.6%) at a median of 16 days (IQR, 7-33 days) postoperatively. The development of VTE was associated with older age (mean, 68 years vs 52 years; P = .0001), male gender (P = .007), and nonambulatory status postoperatively (P < .0001).
  
  
  CONCLUSIONS
  VTE occurs infrequently in postoperative meningioma patients who receive combined modality VTE prophylaxis. VTE risk factors in these patients include advanced age, male gender, and nonambulatory status postoperatively.
authors.affiliation: Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Gerber
authors.forename: Jodi B
authors.initials: JB
authors.lastname: Segal
authors.forename: Amandeep
authors.initials: A
authors.lastname: Salhotra
authors.forename: Alessandro
authors.initials: A
authors.lastname: Olivi
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Grossman
authors.forename: Michael B
authors.initials: MB
authors.lastname: Streiff
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery*; D008579:Meningioma / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D013997:Time Factors; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control