Venous Thromboembolism Prophylaxis in Elective Neurosurgery: A Survey of Board-Certified Neurosurgeons in the United States and Updated Literature Review
| Autor: | Nimer Adeeb, Basel Musmar, Abdallah Adeeb, Krystle Trosclair, Tariq Hattab, Bharat Guthikonda, Christoph J. Griessenauer, Amey Savardekar, Fareed Jumah |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment education Tumor resection Neurosurgery Vte prophylaxis Neurosurgical Procedures 03 medical and health sciences Postoperative Complications 0302 clinical medicine Spine surgery Surveys and Questionnaires medicine Humans Practice Patterns Physicians' Craniotomy business.industry General surgery Incidence (epidemiology) Venous Thromboembolism Checklist Neurosurgeons Elective Surgical Procedures 030220 oncology & carcinogenesis Surgery Neurology (clinical) business Venous thromboembolism 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 150:e631-e638 |
| ISSN: | 1878-8750 |
| Popis: | Background Venous thromboembolism (VTE) remains the single most important preventable cause of morbidity and mortality following neurosurgical procedures, with an incidence of approximately 16%. In the absence of stringent guidelines, the variation in current practice patterns could be considerable and was the underlying basis for this study. Objectives Our objective is to evaluate the modality of thromboprophylaxis used by neurosurgeons. Methods In line with “CHERRIES” (Checklist for Reporting Results of Internet E-Surveys) guidelines, an online survey regarding postoperative VTE prophylaxis following elective neurosurgical procedures was created using Google Forms and distributed to 1500 board-certified neurosurgeons in the United States. Results A total of 370 board-certified neurosurgeons (24.7%) responded to the survey. Sequential compression device was the only primary method of thromboprophylaxis used by 27.2% and 26.5% of respondents after elective craniotomy for tumor resection and spine surgery, respectively. Of the chemical prophylaxis, subcutaneous heparin 5000 U every 8 hours was the most commonly used medication followed by enoxaparin 40 mg daily. Most responders were comfortable starting chemical prophylaxis on postoperative day 1, followed by day 2 and day 3 in both types of surgeries. The mean postoperative time of chemical prophylaxis initiation was significantly more delayed by respondents with longer years in practice. Conclusions This study highlights the variation in practice between neurosurgeons in managing postoperative VTE prophylaxis after elective spine and cranial surgeries. In lieu of this variation, our results showed that most neurosurgeons are comfortable starting chemical prophylaxis as soon as postoperative day 1 following both types of procedures. |
| Databáze: | OpenAIRE |
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