title: Outcomes in neurosurgical patients who develop venous thromboembolism: a review of the RIETE registry.
abstract: OBJECTIVE
  Registro Informatizado de Enfermedad TromboEmbólica (RIETE) database was used to investigate whether neurosurgical patients with venous thromboembolism (VTE) were more likely to die of bleeding or VTE and the influence of anticoagulation on these outcomes.
  
  
  METHODS
  Clinical characteristics, treatment details, and 3-month outcomes were assessed in those who developed VTE after neurosurgery.
  
  
  RESULTS
  Of 40 663 patients enrolled, 392 (0.96%) had VTE in less than 60 days after neurosurgery. Most patients in the cohort (89%) received initial therapy with low-molecular-weight heparin, (33% received subtherapeutic doses). In the first week, 10 (2.6%) patients died (8 with pulmonary embolism [PE], no bleeding deaths; P = .005). After the first week, 20 (5.1%) patients died (2 with fatal bleeding, none from PE). Overall, this cohort was more likely to develop a fatal PE than a fatal bleed (8 vs 2 deaths, P = .058).
  
  
  CONCLUSIONS
  Neurosurgical patients developing VTE were more likely to die from PE than from bleeding in the first week, despite anticoagulation.
authors.affiliation: Department of Nursing/Critical Care, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA lcotemx3@sbcglobal.net lcote@northshore.org.
authors.forename: Lauren P
authors.initials: LP
authors.lastname: Cote
authors.affiliation: Department of Anesthesia/Critical Care, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Greenberg
authors.affiliation: Division of Vascular Surgery, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Caprini
authors.affiliation: Department of Neurosurgery, Evanston Hospital, NorthShore University HealthSystem, Chicago, IL, USA.
authors.forename: James
authors.initials: J
authors.lastname: Stone
authors.affiliation: Department of General Surgery, Hospital Universitario Virgen de las Nieves, Granada, Spain.
authors.forename: Juan I
authors.initials: JI
authors.lastname: Arcelus
authors.affiliation: Department of Internal Medicine, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: Luciano
authors.initials: L
authors.lastname: López-Jiménez
authors.affiliation: Department of Internal Medicine, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Rosa
authors.affiliation: Department of Internal Medicine, Municipal Hospital of Dresden Friedrichstadt, Dresden, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schellong
authors.affiliation: Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Monreal
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D011655:Pulmonary Embolism / Q000401:mortality; D012042:Registries; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality
chemical_list: D000925:Anticoagulants
keywords: anticoagulants; bleeding; pulmonary embolism; venous thromboembolism