PMID- 31525483
OWN - NLM
STAT- MEDLINE
DCOM- 20200203
LR  - 20200203
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 133
DP  - 2020 Jan
TI  - A Survey of Chemoprophylaxis Techniques in Spine Surgery Among American 
      Neurosurgery Training Programs.
PG  - e428-e433
LID - S1878-8750(19)32463-5 [pii]
LID - 10.1016/j.wneu.2019.09.033 [doi]
AB  - BACKGROUND: A paucity of randomized trials have compared prophylactic dose of 
      unfractionated heparin (UFH) versus low-molecular-weight heparin (LMWH) for the 
      prevention of venous thromboembolic events in spinal surgery. Our objective was 
      to determine the most prevalent chemoprophylactic techniques in spine surgery. 
      METHODS: The Accreditation Council for Graduate Medical Education was queried for 
      all neurosurgical residency programs, which were subsequently sent an electronic 
      survey about prophylactic UFH versus LMWH in spine surgery for (1) 
      degenerative/deformity, (2) traumatic, and (3) neoplastic pathologies. RESULTS: 
      Of 69 unique responding residencies, the first dose of chemoprophylaxis for 
      degenerative/deformity spinal disease started most commonly on postoperative day 
      (POD) 1 in 75.3% of neurosurgery programs, followed by POD 2 in 10.1% of 
      programs, POD 0 (same day of surgery) in 8.7% of programs, POD 3 in 1.4% of 
      programs, and morning of surgery in 1.4% of programs. Choice of postoperative 
      chemoprophylaxis did not differ statistically significantly between UFH versus 
      LMWH: 56.5% versus 36.2% in degenerative/deformity pathologies (P = 0.080) and 
      50.7% versus 43.4% in traumatic pathologies (P = 0.535). Three programs (4.3%) in 
      both the degenerative/deformity and trauma groups documented no chemoprophylaxis. 
      Neoplastic pathologies saw a statistically significantly higher proportion of 
      prophylactic UFH (60.8%) compared with prophylactic LMWH (36.2%) (P = 0.037). One 
      program (1.4%) in the neoplastic group did not utilize chemoprophylaxis. Two 
      institutions (2.8%) in the degenerative/deformity cohort and 1 institution (1.4%) 
      in the trauma and cancer cohorts reported "other". CONCLUSIONS: Prophylactic UFH 
      was statistically more common than LMWH in neoplastic spinal surgery, but not in 
      the degenerative/deformity and trauma groups (cohorts). Further trials are 
      warranted.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Macki, Mohamed
AU  - Macki M
AD  - Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Haider, Sameah A
AU  - Haider SA
AD  - Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Anand, Sharath Kumar
AU  - Anand SK
AD  - Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Fakih, Mohamed
AU  - Fakih M
AD  - Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Elmenini, Jaafar
AU  - Elmenini J
AD  - Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Suryadevara, Raviteja
AU  - Suryadevara R
AD  - Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
FAU - Chang, Victor
AU  - Chang V
AD  - Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA. 
      Electronic address: vchang1@hfhs.org.
LA  - eng
PT  - Journal Article
DEP - 20190913
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Chemoprevention/methods
MH  - Drug Administration Schedule
MH  - Health Care Surveys
MH  - Heparin/administration & dosage/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*therapeutic use
MH  - Humans
MH  - Internship and Residency
MH  - Neurosurgery/*education
MH  - *Neurosurgical Procedures
MH  - Postoperative Complications/*prevention & control
MH  - Spinal Diseases/*surgery
MH  - Spinal Neoplasms/surgery
MH  - United States
MH  - Venous Thromboembolism/*prevention & control
OTO - NOTNLM
OT  - Chemoprophylaxis
OT  - Heparin
OT  - LMWH
OT  - Low-molecular-weight heparin
OT  - Spine
OT  - UFH
OT  - Unfractionated heparin
EDAT- 2019/09/17 06:00
MHDA- 2020/02/06 06:00
CRDT- 2019/09/17 06:00
PHST- 2019/07/03 00:00 [received]
PHST- 2019/09/06 00:00 [revised]
PHST- 2019/09/07 00:00 [accepted]
PHST- 2019/09/17 06:00 [pubmed]
PHST- 2020/02/06 06:00 [medline]
PHST- 2019/09/17 06:00 [entrez]
AID - S1878-8750(19)32463-5 [pii]
AID - 10.1016/j.wneu.2019.09.033 [doi]
PST - ppublish
SO  - World Neurosurg. 2020 Jan;133:e428-e433. doi: 10.1016/j.wneu.2019.09.033. Epub 
      2019 Sep 13.