Abstract
BackgroundNeurosurgical patients are varied, encompassing cranial and spinal diseases and trauma, and are admitted under both elective and emergency settings. In all settings, neurosurgery patients are at risk of deep vein thrombosis. D-dimer and ultrasound Doppler have long been good screening and confirmatory tools for the diagnosis of deep vein thrombosis (DVT). We conducted a study to identify the factors associated with DVT among neurosurgical patients, and the overall rate of occurrence at our centre. We aimed to also compare our results to the incidence in similar studies elsewhere in which more judicious use of pharmacological prophylaxis was undertaken. We also included the Well’s score to validate its usefulness in screening for DVT in our local setting.MethodsAll patients admitted into our centre were screened for eligibility and those who underwent surgery from September 2016 to September 2017 had a D-dimer screening after surgery, followed by an ultrasound Doppler if the former was positive. The choice of anticoagulant therapy was not influenced by this study, and observation of the use was in keeping with usual practices in our centre was done.ResultsA total number of 331 patients were recruited in this study, however, after the inclusion and exclusion criteria had been met, 320 patients remained eligible, i.e. suitable for analysis. The mean age of our patients was 46 years, with 66% being male patients. A majority of the cases in this study were cranial related, with only 5% being spine surgeries. On the multivariate analysis, the Well’s score and the number of days in bed remained statistically significant, after adjusting for age group, gender, ethnicity, type of central venous access and type of DVT prophylaxis with an adjusted odd’s ratio, and a confidence interval of 95%, and P < 0.05 for each.ConclusionWell’s scoring and number of days in bed were independent factors affecting the rate of DVT in patients undergoing neurosurgical procedures in our centre.
Highlights
Venous thromboembolism is a significant health issue on a global scale, affecting a wide variety of people, for an wide variety of reasons
We aimed to identify the risk factors associated with the development of deep vein thrombosis (DVT) in neurosurgical patients, with the objective of being able to identify types of patients with the highest risks in our given cohort and to assist the neurosurgeon in deciding on patients who would benefit from more aggressive coverage with anticoagulants
We further looked at D-dimer values to compare with the limits that had been suggested in other studies
Summary
Venous thromboembolism is a significant health issue on a global scale, affecting a wide variety of people, for an wide variety of reasons. The development of DVT is a constant risk in any hospital setting. Most DVTs are occult and can resolve spontaneously, complications from it arises when the clot dislodges and blocks narrower veins of major organs such as the heart, lung and brain, which can result in catastrophic outcome. A multitude of risk factors such as oral contraceptive pills, obesity, prolonged bed rest and immobility contribute to the added chances of developing DVT. Certain medical conditions such as malignancies and Factor V Leiden have been shown to increase the risk of developing DVT [1, 2]. Neurosurgery patients are at risk of deep vein thrombosis. We included the Well’s score to validate its usefulness in screening for DVT in our local setting
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
