PMID- 34166830
OWN - NLM
STAT- MEDLINE
DCOM- 20211108
LR  - 20211108
IS  - 1878-8769 (Electronic)
IS  - 1878-8750 (Linking)
VI  - 153
DP  - 2021 Sep
TI  - Unfractionated Heparin TID Dosing Regimen Is Associated With a Lower Rate of 
      Pulmonary Embolism When Compared With BID Dosing in Patients Undergoing 
      Craniotomy.
PG  - e147-e152
LID - S1878-8750(21)00907-4 [pii]
LID - 10.1016/j.wneu.2021.06.076 [doi]
AB  - BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) 
      and pulmonary embolism (PE), and intracranial hemorrhage (ICH) may complicate the 
      post-operative course of patients undergoing craniotomy. While prophylaxis with 
      unfractionated heparin (UFH) has been shown to reduce VTE rates, twice-daily 
      (BID) and three-times-daily (TID) UFH dosing regimens have not been compared in 
      neurosurgical procedures. The objective of this study was to explore the 
      association between UFH dosing regimen and rates of VTE and ICH in craniotomy 
      patients. METHODS: A retrospective chart review was conducted for 159 patients at 
      Northwestern University receiving 5000 units/0.5 mL UFH injections either BID 
      (n = 132) or TID (n = 27). General linear regression models were run to predict 
      rates of DVT, PE, and reoperation due to bleeding from UFH dosing regimen while 
      controlling for age at surgery, sex, VTE history, craniotomy for tumor resection, 
      surgery duration, length of stay, reoperation, infections, and IDH/MGMT 
      mutations. RESULTS: Receiving UFH TID was significantly associated with a lower 
      rate of PE when compared with receiving UFH BID (beta = -0.121, P = 0.044; TID 
      rate = 0%, BID rate = 10.6%). UFH TID also showed a trend toward lower rates 
      of DVT (beta = -0.0893, P = 0.295; TID rate = 18.5%, BID rate = 21.2%) when compared 
      with UFH BID. UFH TID showed no significant difference in rate of reoperation 
      for bleeding when compared to UFH BID (beta = -0.00623, P = 0.725; TID rate = 0%, 
      BID rate = 0.8%). CONCLUSIONS: UFH TID dosing is associated with lower rates of 
      PE when compared with BID dosing in patients undergoing craniotomy.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Thirunavu, Vineeth
AU  - Thirunavu V
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
FAU - Kandula, Viswajit
AU  - Kandula V
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
FAU - Shah, Parth
AU  - Shah P
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
FAU - Yerneni, Ketan
AU  - Yerneni K
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
FAU - Karras, Constantine L
AU  - Karras CL
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
FAU - Abecassis, Zachary A
AU  - Abecassis ZA
AD  - Department of Neurological Surgery, University of Washington School of Medicine, 
      Seattle, Washington, USA.
FAU - Bloch, Orin
AU  - Bloch O
AD  - Department of Neurological Surgery, University of California, Davis School of 
      Medicine, Sacramento, California, USA.
FAU - Potts, Matthew
AU  - Potts M
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
FAU - Jahromi, Babak
AU  - Jahromi B
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA.
FAU - Tate, Matthew C
AU  - Tate MC
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, USA. Electronic address: mtate@nm.org.
LA  - eng
PT  - Journal Article
DEP - 20210621
PL  - United States
TA  - World Neurosurg
JT  - World neurosurgery
JID - 101528275
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*administration & dosage
MH  - Brain Neoplasms/surgery
MH  - *Craniotomy
MH  - Drug Administration Schedule
MH  - Female
MH  - Glioblastoma/surgery
MH  - Hematoma/surgery
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Intracranial Hemorrhages/chemically induced/*epidemiology
MH  - Linear Models
MH  - Male
MH  - Meningeal Neoplasms/surgery
MH  - Meningioma/surgery
MH  - Middle Aged
MH  - Postoperative Complications/epidemiology/*prevention & control
MH  - Postoperative Hemorrhage/chemically induced/*epidemiology
MH  - Pulmonary Embolism/epidemiology/*prevention & control
MH  - Reoperation
MH  - Retrospective Studies
MH  - Venous Thrombosis/epidemiology/*prevention & control
MH  - Young Adult
OTO - NOTNLM
OT  - Craniotomy
OT  - Pulmonary embolism
OT  - TID/BID dosing
OT  - Unfractionated heparin
OT  - Venous thromboembolism
EDAT- 2021/06/25 06:00
MHDA- 2021/11/09 06:00
CRDT- 2021/06/24 20:13
PHST- 2021/05/01 00:00 [received]
PHST- 2021/06/12 00:00 [revised]
PHST- 2021/06/14 00:00 [accepted]
PHST- 2021/06/25 06:00 [pubmed]
PHST- 2021/11/09 06:00 [medline]
PHST- 2021/06/24 20:13 [entrez]
AID - S1878-8750(21)00907-4 [pii]
AID - 10.1016/j.wneu.2021.06.076 [doi]
PST - ppublish
SO  - World Neurosurg. 2021 Sep;153:e147-e152. doi: 10.1016/j.wneu.2021.06.076. Epub 
      2021 Jun 21.