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Erschienen in: European Archives of Oto-Rhino-Laryngology 7/2023

15.05.2023 | Otology

Stratifying the risks of venous thromboembolism in the lateral skull base surgery using Caprini risk assessment model

verfasst von: Huiying Sun, Songbo Xue, Yu Huang, Yang Zhao, Xu Tian, Zhiqiang Gao, Guodong Feng

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 7/2023

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Abstract

Purpose

To analyze and stratify the possible risk factors of venous thromboembolism (VTE) in lateral skull base surgery (LSBS) using the Caprini risk assessment model.

Methods

In a single center, a retrospective study was conducted with patients who underwent LSBS from June 2016 to August 2021. The clinical characteristics and blood chemistry tests were collected. The incidence of VTE within 30 days of surgery was recorded. The Caprini risk score was calculated to assess the postoperative VTE risk.

Results

Among the 123 patients in this study, the VTE incidence within 30 postoperative days was 8.9%. The total Caprini risk score in VTE patients (5.6 ± 1.9 points) was significantly higher than that of non-VTE patients (4.6 ± 1.4 points; p = 0.028). The binary logistic regression showed the total Caprini score as the only independent indicator of postoperative VTE. The receiver operating characteristic curve analysis showed that the Caprini score at 6.5 points had low sensitivity (36.4%) but high specificity (91.1%), with the largest area under the curve being 0.659. The VTE rate was significantly higher in patients with a total Caprini score ≥ 7 points (28.6%) compared to those with a total Caprini score ≤ 6 points (7.3%; p = 0.022).

Conclusion

LSBS patients have a high risk of developing postoperative VTE. Patients with a Caprini score ≥ 7 points had a significantly higher risk of developing VTE after LSBS. The Caprini risk system was useful in assessing the VTE risk in LSBS. However, more data, calibration, and validation are necessary to establish an exclusive Caprini risk system for LSBS.
Literatur
13.
Zurück zum Zitat Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, Gibbs JS, Huisman MV, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindler TH, Svitil P, VonkNoordegraaf A, Zamorano JL, Zompatori M (2014) 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35:3033–3069. https://doi.org/10.1093/eurheartj/ehu283. (3069a-3069k)CrossRefPubMed Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, Gibbs JS, Huisman MV, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindler TH, Svitil P, VonkNoordegraaf A, Zamorano JL, Zompatori M (2014) 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35:3033–3069. https://​doi.​org/​10.​1093/​eurheartj/​ehu283. (3069a-3069k)CrossRefPubMed
15.
Zurück zum Zitat Ugo Fisch DM (1988) Microsurgery of the skull base. Georg Thieme Verlag Stuttgart, Thieme Medical Publishers, Inc., New York Ugo Fisch DM (1988) Microsurgery of the skull base. Georg Thieme Verlag Stuttgart, Thieme Medical Publishers, Inc., New York
16.
Zurück zum Zitat Zanoletti E, Martini A, Emanuelli E, Mazzoni A (2012) Lateral approaches to the skull base. Acta Otorhinolaryngol Ital 32:281–287PubMedPubMedCentral Zanoletti E, Martini A, Emanuelli E, Mazzoni A (2012) Lateral approaches to the skull base. Acta Otorhinolaryngol Ital 32:281–287PubMedPubMedCentral
20.
Zurück zum Zitat Algattas H, Damania D, DeAndrea-Lazarus I, Kimmell KT, Marko NF, Walter KA, Vates GE, Jahromi BS (2018) Systematic review of safety and cost-effectiveness of venous thromboembolism prophylaxis strategies in patients undergoing craniotomy for brain tumor. Neurosurgery 82:142–154. https://doi.org/10.1093/neuros/nyx156CrossRefPubMed Algattas H, Damania D, DeAndrea-Lazarus I, Kimmell KT, Marko NF, Walter KA, Vates GE, Jahromi BS (2018) Systematic review of safety and cost-effectiveness of venous thromboembolism prophylaxis strategies in patients undergoing craniotomy for brain tumor. Neurosurgery 82:142–154. https://​doi.​org/​10.​1093/​neuros/​nyx156CrossRefPubMed
21.
Zurück zum Zitat Wang X, Zhang Y, Fang F, Jia L, You C, Xu P, Faramand A (2021) Comparative efficacy and safety of pharmacological prophylaxis and intermittent pneumatic compression for prevention of venous thromboembolism in adult undergoing neurosurgery: a systematic review and network meta-analysis. Neurosurg Rev 44:721–729. https://doi.org/10.1007/s10143-020-01297-0CrossRefPubMed Wang X, Zhang Y, Fang F, Jia L, You C, Xu P, Faramand A (2021) Comparative efficacy and safety of pharmacological prophylaxis and intermittent pneumatic compression for prevention of venous thromboembolism in adult undergoing neurosurgery: a systematic review and network meta-analysis. Neurosurg Rev 44:721–729. https://​doi.​org/​10.​1007/​s10143-020-01297-0CrossRefPubMed
25.
Zurück zum Zitat Chang MT, Jitaroon K, Song S, Roozdar P, Wangworat Y, Ibrahim N, Ma Y, Rao VK, Chang SD, Fernandez-Miranda JC, Patel ZM, Dodd RL, Hwang PH, Harsh GR, Nayak JV (2022) Venous thromboembolism rates and risk factors following endoscopic skull base surgery. Int Forum Allergy Rhinol 12:935–941. https://doi.org/10.1002/alr.22943CrossRefPubMed Chang MT, Jitaroon K, Song S, Roozdar P, Wangworat Y, Ibrahim N, Ma Y, Rao VK, Chang SD, Fernandez-Miranda JC, Patel ZM, Dodd RL, Hwang PH, Harsh GR, Nayak JV (2022) Venous thromboembolism rates and risk factors following endoscopic skull base surgery. Int Forum Allergy Rhinol 12:935–941. https://​doi.​org/​10.​1002/​alr.​22943CrossRefPubMed
30.
Zurück zum Zitat Caprini JA, Arcelus JI, Hasty JH, Tamhane AC, Fabrega F (1991) Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost 17(Suppl 3):304–312PubMed Caprini JA, Arcelus JI, Hasty JH, Tamhane AC, Fabrega F (1991) Clinical assessment of venous thromboembolic risk in surgical patients. Semin Thromb Hemost 17(Suppl 3):304–312PubMed
33.
Zurück zum Zitat Zhang Y, Cao M, Ren J (2021) NLR value and IL-18 level and their clinical significance in patients with deep vein thrombosis after receiving the surgery for spinal degeneration. Am J Transl Res 13:7156–7163PubMedPubMedCentral Zhang Y, Cao M, Ren J (2021) NLR value and IL-18 level and their clinical significance in patients with deep vein thrombosis after receiving the surgery for spinal degeneration. Am J Transl Res 13:7156–7163PubMedPubMedCentral
Metadaten
Titel
Stratifying the risks of venous thromboembolism in the lateral skull base surgery using Caprini risk assessment model
verfasst von
Huiying Sun
Songbo Xue
Yu Huang
Yang Zhao
Xu Tian
Zhiqiang Gao
Guodong Feng
Publikationsdatum
15.05.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 7/2023
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-023-07984-0

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