Department of Otolaryngology-Head and Neck Surgery, Ascension Macomb-Oakland Hospital, Madison Heights, Michigan, U.S.A.
Michigan Ear Institute, Farmington Hills, Michigan, U.S.A.
Laryngoscope. 2022 Mar;132(3):662-667. doi: 10.1002/lary.29889. Epub 2021 Oct 11.
Venous thromboembolism (VTE) is a major cause of morbidity and mortality for surgical patients. This article aims to determine factors that may have contributed to the development of VTE in patients undergoing lateral skull base surgery, to assess the validity of the Caprini Risk Assessment Model (RAM) score in this subset of patients, and to determine the efficacy of mechanical DVT prophylaxis alone in preventing VTE.
Retrospective chart review.
A retrospective chart review was conducted of patients who underwent skull base surgery for vestibular schwannoma, and the rate of VTE was assessed. Patient demographics, comorbidities, and treatment factors were examined to determine risk factors associated with the development of a postoperative thrombotic event. Caprini RAM scores were compared for patients who developed a VTE.
Among 197 patients, the rate of VTE formation was 3.5%. No individual risk factor independently contributed to the development of a thrombotic event. The mean Caprini RAM score was 4.06 in patients who did not develop a VTE and 5.14 in the patients that did develop a VTE (P = .005). The Caprini score was significant for the risk of VTE formation, with an odds ratio of 2.8 (P = .009, 95% CI = 1.3-6.2).
Venous thromboembolism rates are relatively low following lateral skull base surgery. While there is no individual risk factor associated with increased VTE risk, the Caprini RAM score appears to be a useful predictor of risk. The Caprini score may be useful in identifying high-risk patients who may benefit from chemoprophylaxis for VTE prevention.
3 Laryngoscope, 132:662-667, 2022.
静脉血栓栓塞症（VTE）是外科患者发病率和死亡率的主要原因。本文旨在确定导致接受侧颅底手术患者发生 VTE 的因素，评估 Caprini 风险评估模型（RAM）评分在这部分患者中的有效性，并确定单独使用机械性 DVT 预防在预防 VTE 中的效果。
回顾性图表回顾。
对接受侧颅底手术治疗前庭神经鞘瘤的患者进行回顾性图表回顾，并评估 VTE 的发生率。检查患者的人口统计学、合并症和治疗因素，以确定与术后血栓事件发生相关的危险因素。比较发生 VTE 的患者的 Caprini RAM 评分。
在 197 例患者中，VTE 形成率为 3.5%。没有任何单一危险因素独立导致血栓事件的发生。未发生 VTE 的患者的平均 Caprini RAM 评分为 4.06，发生 VTE 的患者为 5.14（P =.005）。Caprini 评分对 VTE 形成风险具有显著意义，优势比为 2.8（P =.009，95%CI=1.3-6.2）。
接受侧颅底手术后 VTE 发生率相对较低。虽然没有与增加 VTE 风险相关的单一危险因素，但 Caprini RAM 评分似乎是风险预测的有用指标。Caprini 评分可能有助于识别高风险患者，这些患者可能受益于化学预防以预防 VTE。
3 Laryngoscope, 132:662-667, 2022.
