title: Risk assessment for venous thromboembolism in patients with neuroepithelial tumors: pretreatment score to identify high risk patients.
abstract: The independent risk factors for venous thromboembolism (VTE) were investigated in patients with neuroepithelial tumor to establish a risk score for VTE. Our prospective study enrolled 395 hospitalized cases with neuroepithelial tumors. All cases underwent measurement of serum D-dimer concentration and neurological examination on admission. Serum D-dimer concentration was measured on days 1, 3, and 7 after surgery and weekly during follow up in patients who underwent surgery, and once a week during follow up in patients without surgery. Fourteen clinical parameters were evaluated as indicators of VTE, and among them, age, body-mass index, chemotherapy, radiation therapy, corticosteroid usage, pretreatment serum D-dimer concentration, paresis of the lower extremity (manual muscle test: MMT), performance status, and World Health Organization grade of the tumor achieved statistical significance. Multivariable logistic regression analysis demonstrated age >65 years, corticosteroid usage, paresis of the lower extremity, and serum D-dimer concentration over 1.0 mg/dl were independent factors. Total risk score was defined as the total of the scores for risk factors assigned based on the adjusted odds ratio: pretreatment serum D-dimer concentration over 1.0 mg/dl (2 points), and age over 65 years old, paresis of the lower extremity of MMT ≤2, and corticosteroid usage (1 point each). Rates of VTE were 2.0% in the low risk (total score 0 or 1), 14.8% in the intermediate risk (total score 2 or 3), and 51.9% in the high risk groups (total score = 4 or 5). This pretreatment risk score for VTE might be useful to identify patients who would benefit from thromboprophylaxis.
authors.affiliation: Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kumabe
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanamori
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saito
authors.forename: Yoji
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Sonoda
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D018302:Neoplasms, Neuroepithelial / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000517:prevention & control*; D018570:Risk Assessment / Q000145:classification; D014057:Tomography, X-Ray Computed; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000517:prevention & control*; D051598:Whole Body Imaging; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D