title: Venous Thromboembolism in Patients Undergoing Craniotomy for Brain Tumors: A U.S. Nationwide Analysis.
abstract: BackgroundPatients who undergo craniotomy for brain tumor have an increased risk of developing venous thromboembolism (VTE). Using the National Surgical Quality Improvement Program (NSQIP) registry, patients undergoing craniotomy for brain tumor from 2006 and 2014 were analyzed to identify risk factors for postoperative VTE.MethodsThe study population, identified by Current Procedural Terminology codes, included all NSQIP-reported patients who underwent a craniotomy for brain tumor resection.ResultsThere were 629 instances of VTE among 19,409 craniotomies for brain tumor (3.2%) recorded in NSQIP. Occurrence of VTE was associated with other postoperative complications on univariate analysis, including pneumonia, respiratory failure, stroke, and sepsis (allp< 0.001). On multivariate analysis, independent predictors of VTE included age 46 to 57 years (odds ratio [OR], 1.432;p= 0.006), 57 to 66 years (OR, 1.550;p= 0.001), or over 66 years (OR, 2.493;p< 0.001), body mass index (BMI) over 32.1 kg/m2(OR, 1.835;p< 0.001), functional dependence (OR, 1.657;p< 0.001), ventilator dependence (OR, 2.516;p< 0.001), steroid use (OR, 1.661;p< 0.001), prior sepsis (OR, 1.845;p< 0.001), and total operative time 183 to 271 minutes (OR, 1.462;p= 0.032) and longer than 271 minutes (OR, 1.945;p< 0.001).ConclusionsVTE occurs in approximately 3% of patients undergoing craniotomy for brain tumor resection. Independent predictors for developing VTE include older age, higher BMI, recent steroid use, and total operative time.
authors.affiliation: Department of Neurosurgery, Cushing Neurosurgery Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: David J
authors.initials: DJ
authors.lastname: Cote
authors.affiliation: Department of Neurosurgery, Cushing Neurosurgery Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Heloise M
authors.initials: HM
authors.lastname: Dubois
authors.affiliation: Department of Neurosurgery, Cushing Neurosurgery Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Aditya V
authors.initials: AV
authors.lastname: Karhade
authors.affiliation: Department of Neurosurgery, Cushing Neurosurgery Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000150:complications*; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States; D054556:Venous Thromboembolism / Q000209:etiology*