PB0430 - Three-month incidence of venous thromboembolism in Thai patients who underwent neurological surgeries

Sunday, June 23, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Petnumnueng ponsumritchok

Medical student
Faculty of Medicine, Chiang Mai University
Chiang Mai, Chiang Mai, Thailand

Co-Author(s)

PC

Praepattra Chaijaroen

Medical student
Faculty of Medicine, Chiang Mai University
Chiang Mai, Chiang Mai, Thailand
TA

Tin Ayurag

Medical student
Faculty of Medicine, Chiang Mai University
Chiang Mai, Chiang Mai, Thailand
NS

Nattaphan Siritikul

Medical student
Faculty of Medicine, Chiang Mai University
Chiang Mai, Chiang Mai, Thailand
PN

Piangrawee Niprapan

associate researcher
Division of Hematology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Chiang Mai, Chiang Mai, Thailand
Nonthakorn Hantrakun, MD

Hematologist
Division of Hematology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Chiang Mai, Chiang Mai, Thailand
JV

Jirapong Vongsfak

Instructor
Department of neurosurgery, Faculty of Medicine, Chiang Mai University
Chiang Mai, Chiang Mai, Thailand
Chatree Chai-Adisaksopha, MD

Associate Professor
Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand
Chiang Mai, Chiang Mai, Thailand

Background: Venous thromboembolism (VTE) is a complication with a significant effect on morbidity and mortality of neurosurgical patients. The incidences of VTE in patients underwent neurological surgeries vary due to factors such as race, co-morbidities or type of surgery.

Aims: The objectives were to assess the incidence and risk factors of VTE, bleeding and all-cause mortality in patients undergoing neurological surgery.

Methods: This retrospective cohort study was conducted at a single center, a university-based hospital in Thailand. Inclusion criteria comprised patients aged 15 years or older who were admitted for elective or emergency neurosurgery. Patients with preoperative VTE diagnosed within three months or a history of anticoagulant use were excluded. Outcomes measured included the 90-day incidences of VTE, any bleeding, major bleeding, and mortality.

Results: Between January 2021 and December 2022, a total of 626 patients were included. The mean age was 50.21±17.37 years, and 55.27% were males. Thromboprophylaxis was administered to 86 patients (13.74%, 95% CI 11.14-16.69). Fourteen patients were confirmed to have symptomatic VTE, resulting in an incidence of 2.24%, with a 95% confidence interval (CI) of 1.23-3.72. Patients aged ≥75 years (HR 4.53; 95% CI 1.25-16.38; P=0.021), those with cancer (HR 8.51; 95% CI 2.95-24.60, P < 0.001), and those experiencing postoperative paraparesis/paralysis (HR 3.25; 95% CI 1.12-9.45; P=0.030) were associated with an increased risk of postoperative VTE. Fifty-three patients (8.47%, 95% CI 6.41-10.93) experienced any bleeding, with 23 patients (3.67%, 95% CI 2.34-5.46) having major bleeding. The incidence of postoperative mortality was 6.55%, with a 95% CI of 4.74-8.78.

Conclusion(s): This study revealed that elderly patients, those with cancer or those experiencing postoperative paraparesis/paralysis were at higher risk of VTE.