Abstract

Introduction. Patients with brain tumors are at increased risk for the development of venous thromboembolism (VTE). The most effective prevention method today is a combination of mechanical compression of the lower extremities and the introduction of low molecular weight heparin (LMWH). In 2018, an algorithm for the prevention of VTE was introduced in our clinic, which implies the early (in the first 48 h after surgery) administration of LMWH.The study objective is to assess the effect of early LMWH administration on the incidence of intracranial hemorrhage (ICH) after removal of brain tumors.Materials and methods. From January 2014 to December 2019, 3266 patients underwent removal of brain tumors. The group 1 included 2057 patients who were treated in the period before the introduction of the VTE prevention algorithm (2014– 2017), the group 2 included 1209 patients who were treated using this algorithm (2018–2019). In each of the groups, the frequency and timing of ICH were assessed. The severity of complications was assessed according to the F.A.L. Ibanez classification. The data were compared between groups 1 and 2, as well as between patients who received LMWH at the time of ICH and those who did not receive.Results. Patients of the group 1 were prescribed LMWH in 14.3 % of cases, on average on the 4th day after surgery. In this group, 26 (1.26 %) patients developed ICH. Patients of the group 2 were prescribed LMWH in 89 % of cases, on average on the 2nd day. In this group, 15 (1.24 %) patients developed ICH. Severe complications were in 6 (85.7 %) of 7 patients who received LMWH at the time of ICH, and in 25 (73.5 %) of 34 patients who did not receive LMWH (p = 0.66).Conclusion. The widespread use of LMWH for the prevention of VTE during the first 48 h after removal of brain tumors did not lead to an increase in the frequency of ICH. At the same time, patients with ICH who developed during the use of LMWH often had a more severe clinical course.

Highlights

  • Patients with brain tumors are at increased risk for the development of venous thromboembolism (VTE)

  • The most effective prevention method today is a combination of mechanical compression of the lower extremities and the introduction of low molecular weight heparin (LMWH)

  • In 2018, an algorithm for the prevention of VTE was introduced in our clinic, which implies the early administration of LMWH

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Summary

Оригинальная работа

У пациентов с опухолями головного мозга повышен риск развития венозных тромбоэмболических осложнений (ВТЭО). В нашей клинике был внедрен в практику алгоритм профилактики ВТЭО, подразумевающий раннее (в течение 48 ч после операции) назначение НМГ. Цель исследования – оценить влияние раннего назначения НМГ на частоту внутричерепных кровоизлияний (ВЧК) у пациентов, перенесших хирургическое лечение опухолей головного мозга. Сравнивали данные 1‐й и 2‐й групп, а также данные пациентов, получавших и не получавших НМГ на момент возникновения ВЧК. Широкое применение НМГ с целью профилактики ВТЭО в течение 48 ч после удаления опухолей головного мозга не привело к увеличению частоты ВЧК. В то же время у пациентов с ВЧК, развившимся на фоне применения НМГ, его клиническое течение чаще было более тяжелым. Результаты раннего назначения низкомолекуляр‐ ного гепарина с целью профилактики венозных тромбоэмболических осложнений после удаления опухолей голов‐ ного мозга.

Russian Journal of Neurosurgery НЕЙРОХИРУРГИЯ
Introduction
High risk
Параметр Parameter
Статистическая значимость различий р Statistical significance p
Годы Years
Findings
Patients not receiving the drug
Full Text
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