Risk factors and Associated Complications with Symptomatic Venous Thromboembolism in Patients with Craniotomy for Meningioma.

OBJECTIVE: Patients undergoing surgical resection of meningioma are at increased risk for developing venous thromboembolism (VTE). The primary aim of this study was to assess the occurrence of VTE in patients who underwent surgery to remove their meningioma, and to determine the risk factors and associated complications with VTE.

METHODS: The American College of Surgeons(ACS) National Surgical Quality Improvement Project (NSQIP) database from 2012-2015 was reviewed for patients who had undergone meningioma resection according to their primary Current Procedural Terminology codes and International Classification of Diseases, Ninth Revision.

RESULTS: 5036 meningioma patients were included in this study. The rate of VTE in this cohort was 3.38%, with pulmonary embolism (PE) being 1.47%, and 2.42% for deep vein thrombosis (DVT). During the first 30 days following surgery, patients with VTE had a mortality rate of 5.88% compared to only 1.15% for patients without VTE. Multivariate binary logistic regression analysis determined 5 risk factors for VTE, including age ≥ 60 years, American Society of Anesthesiologists(ASA) classification of 3, operative time ≥310 minutes, ventilator dependence and pre-operative transfusions. Univariate analysis revealed a number of occurrence complications significantly associated with VTE, including unplanned intubation, ventilator > 48 hours, stroke, sepsis, septic shock, pneumonia, urinary tract infection(UTI) and transfusions.

CONCLUSIONS: Risk factors for VTE and associated complications were identified. Understanding these risk factors provides physicians with further insight in managing this subgroup of patients in a personalized fashion in the perioperative period to minimize the incidence and morbidity of VTE.