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  • VTE in Patients Undergoing Craniotomy for Brain Tumors: A NSQIP Analysis

    Final Number:
    29

    Authors:
    David J. Cote BS; Heloise H. Dubois; Aditya Vishwas Karhade BE; Timothy R. Smith MD, PhD, MPH

    Study Design:
    Other

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Patients who undergo craniotomy for brain tumors have an increased risk of developing venous thromboembolism (VTE), a condition that can lead to death via pulmonary emboli (PE), prolonged hospital stay, and increased costs. Using the NSQIP database, we analyzed patients with brain tumors undergoing craniotomies to identify risk factors for post-operative VTE from 2006-2014.

    Methods: After IRB approval, all existing NSQIP records were collected and compiled. Our study population, identified by CPT codes, included patients who underwent a craniotomy for brain tumor resection as their primary procedure. Multivariate binary logistic regression was used to identify risk factors for post-operative VTE.

    Results: From 2006 to 2014, there were 629 instances of VTE among 19,409 total cases (3.2%) according to the NSQIP database. On bivariate analysis, 12 additional post-operative complications, including stroke/CVA, post-operative infection, and unplanned intubation were found to be more common in patients with VTE than those without. On multivariate analysis, risk factors for VTE included age (p<0.001), body mass index in the highest quartile (OR=2.190, p<0.001), impaired sensorium (OR=1.889, p=0.016), hemiplegia (OR=1.837, p<0.007), disseminated cancer (OR=0.546, p=0.021), steroid use (OR=1.784, p<0.002), and operation time in the highest quartile (OR=1.893, p=0.012).

    Conclusions: According to the NSQIP database, VTE occurs in about 3% of patients undergoing craniotomy for brain tumor resection. Predictors for developing VTE include age, BMI, impaired sensorium, hemiplegia, steroid use, prior sepsis and total operative time.

    Patient Care: VTE is a common complication after surgical procedures in general, and it is even more common after the resection of brain tumors. We present a "big data" analysis of thousands of operations in an effort to identify risk factors for development of VTE after craniotomy for brain tumor.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Understand risk factors for development of VTE in patients undergoing craniotomy for brain tumors. 2) Appreciate the overall increased risk of VTE in patients undergoing craniotomy for brain tumors.

    References:

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