P12.25 Venous thromboembolism (VTE) after meningioma resection a retrospective case series

摘要

>Introduction: All patients undergoing craniotomies have a considerable risk of developing Venous Thromboembolisms (VTE), deep venous thrombosis (DVT) and pulmonary embolism (PE), postoperatively. The incidence of VTE post meningioma resection reportedly ranges from 2.5% to 8.2%. The aim of this study is to evaluate the incidence and associated factors of VTE in meningioma patients at a single institution between 2005-2016. METHODS: After IRB approval, 1211 consecutive meningioma resections in 1105 patients between January 2005 and August 2016 were retrospectively reviewed. From the hospital’s Research Patient Data Registry, age, ethnicity, gender, tumor location and WHO grade were extracted for all patients with a pathologically proven meningioma. Furthermore, International Code of Disease (ICD) codes for VTE, PE, intracranial hemorrhage, coagulation disease, history of VTE and Vena Cava Filter placement were also extracted and used for statistical analysis. All ICD recorded complications were double checked in the patient records. >Results: Of the 1211 procedures, 48 (4.0%) were complicated by VTE, 13 (1.1%) by PE and 9 (0.9%) by an intracranial hemorrhage that required a craniotomy. In a multivariate logistic regression model including increased age (65 years or older), history of VTE and gender, only older age (OR: 2.096, 95%-CI: 1.162-3.780, p=0.014) and history of VTE (OR: 3.597, 95%-CI: 1.303-9.829, p=0.013) were significantly associated with development of VTE. In multivariate logistic regression analysis, a coagulation disorder was associated with higher incidence of PE (OR: 12.375 95%-CI: 1.434-106.794, p=0.022) and intracranial hemorrhage that required re-craniotomy (OR: 15.875, 95%-CI: 1.698-130.283, P=0.19). CONCLUSION: 4% of the patients operated for meningioma presented post-operatively with clinically relevant VTEs. Patients with a history of VTE are at risk for development of VTE after craniotomy. Coagulopathy is a risk factor for post-operative PE and surgical intracranial hematoma.