Chemical venous thromboembolism prophylaxis in neurosurgical patients: an updated systematic review and meta-analysis.

@article{Khan2018ChemicalVT,
  title={Chemical venous thromboembolism prophylaxis in neurosurgical patients: an updated systematic review and meta-analysis.},
  author={Nickalus R Khan and Prayash G Patel and John P Sharpe and Siang Liao Lee and Jeffrey M. Sorenson},
  journal={Journal of neurosurgery},
  year={2018},
  volume={129 4},
  pages={
          906-915
        }
}
OBJECTIVE Venous thromboembolism (VTE) is a common and potentially life-threatening complication. [...] Key MethodMETHODS In February 2016 a systematic literature review was performed identifying 3944 articles from 4 different databases. A random-effects meta-analysis was performed after identifying the articles that met inclusion criteria. RESULTS Nine articles that met the inclusion criteria were included.Expand
Pharmacologic thromboprophylaxis in adult patients undergoing neurosurgical interventions for preventing venous thromboembolism.
TLDR
In patients undergoing neurosurgical procedures, low certainty of evidence suggests that pharmacologic thromboprophylaxis confers benefit for preventing asymptomatic (screening-detected) proximal DVT with very low certainty regarding its impact on patient-important outcomes. Expand
The incidence of venous thromboembolism following surgical resection of intracranial and intraspinal meningioma. A systematic review and retrospective study
TLDR
The use of routine lower-extremity duplex ultrasound, mechanical prophylaxis, and early mobilization, may have contributed to these lower rates of VTEs in patients with meningiomas, and regular use of LMWH appears to be a safe, but it also did not necessarily lower the rates ofVTE in this cohort. Expand
Incidence and Risk Factors for Venous Thromboembolism Following Craniotomy for Intracranial Tumors: A Cohort Study
TLDR
Patients with intracranial tumor patients with diabetes mellitus and new-onset postoperative motor deficits are the most likely to require VTE prophylaxis with an anticoagulant. Expand
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
TLDR
Based on the available evidence of moderate-to-good quality, IPC is equivalent to anticoagulants for thromboprophylaxis in terms of efficacy and evidence to support or negate the use of pharmacological prophylaxisIn terms of safety is lacking. Expand
Predictors of Venous Thromboembolism After Nonemergent Craniotomy: A Nationwide Readmission Database Analysis.
TLDR
In multivariate analysis, several factors were significantly associated with VTE readmission, namely, craniotomy for tumor, corticosteroids, advanced age, greater length of stay, and discharge to institutional care. Expand
Venous Thromboembolism Prophylaxis in Elective Neurosurgery: A Survey of Board-Certified Neurosurgeons in the United States and Updated Literature Review.
TLDR
It was shown that most neurosurgeons are comfortable starting chemical prophylaxis as soon as postoperative day 1 following both types of procedures, and the mean postoperative time of chemical proPHylaxis initiation was significantly more delayed by respondents with longer years in practice. Expand
Early chemoprophylaxis for deep venous thrombosis does not increase the risk of hematoma expansion in patients presenting with spontaneous intracerebral hemorrhage
TLDR
The use of early chemoprophylaxis against venous thromboembolic events following ICH appears safe in the patient population without increasing the risk of hematoma expansion. Expand
Venous Thromboembolism After Degenerative Spine Surgery: A Nationwide Readmissions Database Analysis.
TLDR
The incidence of readmission with VTE diagnoses in spine surgery is low, however, their devastating consequences underscore the need to identify those patients deemed high risk. Expand
Therapeutic anticoagulation for venous thromboembolism after recent brain surgery: Evaluating the risk of intracranial hemorrhage
TLDR
ICH was not statistically associated with the timing of therapeutic anticoagulation after brain surgery between the 2nd and 29th postoperative days, which may encourage the strategy of early treatment considering the life-threatening potential of VTE. Expand
Surveillance Venous Duplex Ultrasound in the Neurosurgical Population: A Single-Center Quality Improvement Initiative.
TLDR
The findings lend support to pre-operative screening in high-risk patients and suggest that routine post-operative surveillance in asymptomatic patients is unnecessary. Expand
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References

SHOWING 1-10 OF 36 REFERENCES
Venous Thromboembolism Prophylaxis in Patients Undergoing Cranial Neurosurgery: A Systematic Review and Meta-analysis
TLDR
Heparin prophylaxis for patients undergoing elective cranial neurosurgery reduces the risk of VTE but may also increase bleeding risks with a ratio of serious or symptomatic VTE relative to serious bleeding that is only slightly favorable. Expand
Prevention of venous thromboembolism in neurosurgery: a metaanalysis.
TLDR
In a mixed neurosurgical population, LMWH and ICDs are both effective in the prevention of VTE, and isolated high-risk groups may benefit from a combination of prophylactic methods, suggesting the need for a more individualized approach to these patients. Expand
Thromboembolic Disease in Spinal Surgery: A Systematic Review
TLDR
As risk of DVT after routine elective spinal surgery is fairly low, it seems reasonable to use CS with PSCD as a primary method of prophylaxis, and there is insufficient evidence to suggest that screening patients undergoing electives spinal surgery with ultrasound or venogram is routinely warranted. Expand
Low-molecular-weight and unfractionated heparin for prevention of venous thromboembolism in neurosurgery: a meta-analysis.
TLDR
Low-molecular-weight and unfractionated heparin have been shown to be effective for prophylaxis of venous thromboembolism in elective neurosurgery without excessive bleeding risk. Expand
Is chemical antithrombotic prophylaxis effective in elective thoracolumbar spine surgery? Results of a systematic review
TLDR
The current literature does not support the routine use of chemical prophylaxis for low risk patients undergoing low risk spinal procedures, and the incidence of DVT and PE in commonly performed elective posterior spinal procedures is very low. Expand
Incidence of Venous Thromboembolic Complications in Instrumental Spinal Surgeries with Preoperative Chemoprophylaxis
TLDR
It is found that preoperative prophylactic LMWH injection has no major bleeding complications altering postoperative course; still, the issue concerning the initiation time of chemoprophylaxis in spinal surgery remains unclear. Expand
Low molecular weight heparin and compression stockings in the prevention of venous thromboembolism in neurosurgery.
TLDR
This study demonstrates that the low molecular weight heparin, nadroparin, added to graduated compression stockings results in a clinically significant decrease in VTE without inducing any significant increase of major bleeding. Expand
Enoxaparin increases the incidence of postoperative intracranial hemorrhage when initiated preoperatively for deep venous thrombosis prophylaxis in patients with brain tumors.
TLDR
Enoxaparin therapy initiated at the time of anesthesia induction increases postoperative intracranial hemorrhage, and the study was terminated because of the increased incidence of adverse events in the enoxAParin-treated groups. Expand
Low rate of venous thromboembolism after craniotomy for brain tumor using multimodality prophylaxis.
TLDR
Enoxaparin, 40 mg/d, or unfractionated heparin, 5,000 U bid, in combination with graduated compression stockings, intermittent pneumatic compression, and predischarge surveillance venous ultrasonography of the legs resulted in 150 consecutive patients without symptomatic VTE, achieving excellent efficacy and safety. Expand
Venous thromboembolism in neurosurgery and neurology patients: a review.
TLDR
The principles concerning the prophylaxis, diagnosis, and clinical management of venous thromboembolic disease in neurosurgery and neurology patients are dealt with in this review. Expand
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