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September 3, 2010Journal of neurosurgery

Venous thromboembolism: deep venous thrombosis and pulmonary embolism in a neurosurgical population

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Key result

The addition of subcutaneous heparin to mechanical prophylaxis reduced the rate of deep venous thrombosis from 16% to 9% in neurosurgical patients, without increasing hemorrhagic complications.

Why the study?

Does subcutaneous heparin added to mechanical prophylaxis reduce deep venous thrombosis and pulmonary embolism in neurosurgical patients?

Population

2,638 neurosurgical patients admitted between January 2006 and December 2008, including a subgroup of 1,638…

Comparison

Subcutaneous heparin 5000 U twice daily in… vs Mechanical DVT prophylaxis alone.

Design

Cohort

Authors

AKAhmad KhaldiNHNaseem HeloMSMichael Schneck

Discussion

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Overview

May support heparin addition in neurosurgical patients; hypothesis-generating pending RCTs on PE and bleeding.

Study Design

Type

Cohort (n=2,638)

Multicenter

No

Structured PICO

Does subcutaneous heparin added to mechanical prophylaxis reduce deep venous thrombosis and pulmonary embolism in neurosurgical patients?

P
Population
2,638 neurosurgical patients evaluated for the occurrence of venous thromboembolism following the implementation of a pharmacological prophylaxis protocol.
I
Intervention
Subcutaneous heparin 5000 U twice daily (started within 24 or 48 hours postoperatively) in combination with mechanical DVT prophylaxis.
C
Comparator
Mechanical DVT prophylaxis alone (no pharmacological prophylaxis).
O
Outcome
Rate of lower-extremity deep venous thrombosis (DVT) and pulmonary embolism (PE).hard clinical

Main Result

Effect estimate: 43% reduction

Absolute Event Rate: 9% vs 16%

Early pharmacological prophylaxis with subcutaneous heparin in neurosurgical patients significantly reduces DVT risk without increasing bleeding complications, though it may not impact overall PE rates.

Limitations

  • Retrospective study design

Cite This Study

Khaldi et al. (2010) conducted a cohort in Venous thromboembolism in neurosurgical patients (n=2,638). Subcutaneous heparin (pharmacological prophylaxis) vs. Mechanical DVT prophylaxis alone was evaluated on Rate of lower-extremity deep venous thrombosis (DVT) (43% reduction). The addition of subcutaneous heparin to mechanical prophylaxis reduced the rate of deep venous thrombosis from 16% to 9% in neurosurgical patients, without increasing hemorrhagic complications.

synapsesocial.com/papers/6a940662fb64bc88052152cdhttps://doi.org/10.3171/2010.8.jns10332
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Also Consider

Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prophylaxis of venous thromboembolism.1990 · 34 citations
  2. 2The risk and efficacy of anticoagulant therapy in the treatment of thromboembolic complications in patients with primary malignant brain tumors1990 · 72 citations