PMID- 23336127
OWN - NLM
STAT- MEDLINE
DCOM- 20131216
LR  - 20220409
IS  - 1743-1328 (Electronic)
IS  - 0161-6412 (Print)
IS  - 0161-6412 (Linking)
VI  - 35
IP  - 2
DP  - 2013 Mar
TI  - Deep venous thrombosis and pulmonary embolisms in adult patients undergoing 
      craniotomy for brain tumors.
PG  - 206-11
LID - 10.1179/1743132812Y.0000000126 [doi]
AB  - OBJECTIVE: The development of venothromboembolisms (VTEs), including deep vein 
      thrombosis (DVT) and pulmonary emboli (PE), is common in brain tumor patients. 
      Their development can be catastrophic. Studies evaluating pre-operative clinical 
      factors that predispose patients to the development of VTE are few and limited. 
      An understanding may help risk stratify patients and guide subsequent therapy 
      aimed at reducing the risk of DVTs/PEs. METHODS: All adult patients who underwent 
      surgery for an intracranial tumor at an academic tertiary care institution 
      between 1998 and 2008 were retrospectively reviewed. Stepwise multivariate 
      logistical regression analysis was used to identify pre-operative factors 
      associated with the development of peri-operative (within 30 days of surgery) 
      DVTs/PEs among patients who underwent surgery of their intracranial tumor. 
      RESULTS: Of the 4293 patients in this study, 126 (3%) patients developed DVT 
      and/or PE in the peri-operative period. The pre-operative factors independently 
      associated with the development of DVTs/PEs were: poorer Karnofsky performance 
      scale (KPS) [odds ratio (OR), 1.040; 95% confidence interval (CI), 1.026-1.052; 
      P<0.0001], high grade glioma (OR, 1.702; 95% CI, 1.176-2.465; P = 0.005), older 
      age (OR, 1.033; 95% CI, 1.020-1.046; P<0.0001), hypertension (OR, 1.785; 95% CI, 
      1.180-2.699; P = 0.006), and motor deficit (OR, 1.854; 95% CI, 1.244-2.763; P = 
      0.002). Eighty six per cent of the patients with DVTs/PEs were treated with 
      either unfractionated or low molecular weight heparin, and 4% of these patients 
      developed intracranial hemorrhage. DISCUSSION: The present study found that 
      poorer functional status, older age, pre-operative motor deficit, high grade 
      glioma, and hypertension each independently increased the risk of developing 
      peri-operative DVTs/PEs. These findings may provide patients and physicians with 
      prognostic information that may guide therapies aimed at minimizing the 
      development of peri-operative DVTs/PEs.
FAU - Chaichana, Kaisorn L
AU  - Chaichana KL
AD  - Johns Hopkins University School of Medicine, Department of Neurosurgery, 
      Baltimore, MD, USA. kaisorn@jhmi.edu
FAU - Pendleton, Courtney
AU  - Pendleton C
FAU - Jackson, Christopher
AU  - Jackson C
FAU - Martinez-Gutierrez, Juan Carlos
AU  - Martinez-Gutierrez JC
FAU - Diaz-Stransky, Andrea
AU  - Diaz-Stransky A
FAU - Aguayo, Javier
AU  - Aguayo J
FAU - Olivi, Alessandro
AU  - Olivi A
FAU - Weingart, Jon
AU  - Weingart J
FAU - Gallia, Gary
AU  - Gallia G
FAU - Lim, Michael
AU  - Lim M
FAU - Brem, Henry
AU  - Brem H
FAU - Quinones-Hinojosa, Alfredo
AU  - Quinones-Hinojosa A
LA  - eng
GR  - P30 CA006973/CA/NCI NIH HHS/United States
GR  - R25 MH077823/MH/NIMH NIH HHS/United States
PT  - Journal Article
DEP - 20121213
PL  - England
TA  - Neurol Res
JT  - Neurological research
JID - 7905298
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Anticoagulants/adverse effects/therapeutic use
MH  - Brain Neoplasms/complications/*surgery
MH  - Craniotomy/*adverse effects
MH  - Humans
MH  - Middle Aged
MH  - Postoperative Complications/drug therapy/*epidemiology
MH  - Pulmonary Embolism/complications/drug therapy/*epidemiology
MH  - Risk Factors
MH  - Venous Thrombosis/complications/drug therapy/*epidemiology
PMC - PMC3991124
MID - NIHMS565660
EDAT- 2013/01/23 06:00
MHDA- 2013/12/18 06:00
PMCR- 2014/04/18
CRDT- 2013/01/23 06:00
PHST- 2013/01/23 06:00 [entrez]
PHST- 2013/01/23 06:00 [pubmed]
PHST- 2013/12/18 06:00 [medline]
PHST- 2014/04/18 00:00 [pmc-release]
AID - ner3018 [pii]
AID - 10.1179/1743132812Y.0000000126 [doi]
PST - ppublish
SO  - Neurol Res. 2013 Mar;35(2):206-11. doi: 10.1179/1743132812Y.0000000126. Epub 2012 
      Dec 13.