Clinic of Neurosurgery, Clinical Center of Vojvodina, Novi Sad, Serbia.
Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
PLoS One. 2022 Aug 16;17(8):e0273189. doi: 10.1371/journal.pone.0273189. eCollection 2022.
Microsurgical resection of meningiomas in a majority of cases leads to a favorable outcome. Therefore, severe postoperative adverse events are less acceptable. The main purpose of this study was to investigate the incidence of symptomatic venous thromboembolism (VTE) and hemorrhagic complications in patients after operative treatment of intracranial meningiomas and to identify the risk factors in this patient subgroup. Of 106 patients undergoing elective craniotomy for meningioma overall incidence of symptomatic VTE was noted in 5.7% (six patients). For the risk-factor analysis older age (57.20 ± 11.60 vs. 71.00 ± 0.90 years, p < 0.001), higher body mass index (27.60 ± 4.80 vs. 33.16 ± 0.60 kg/m2, p < 0.001), WHO grade II (3.00% vs. 33.33%, p = 0.02), lower intraoperative blood loss (466.00 ± 383.70 vs. 216.70 ± 68.30 mL, p < 0.001), bedridden status and neurologic deficit (0.00% vs. 33.33%, p = 0.003 and 38.00% vs. 100.00%, p = 0.004) were associated with greater VTE risk. No risk factors for hemorrhagic complications were identified on univariate analysis. In conclusion, the incidence of VTE in meningioma patients is not negligible. Identified risk factors should be taken into account in the decision-making process for chemoprophylaxis when the risk of bleeding decreases.
大多数情况下，脑膜瘤的显微切除术可获得良好的结果。因此，严重的术后不良事件不太可接受。本研究的主要目的是调查颅内脑膜瘤手术治疗后症状性静脉血栓栓塞症（VTE）和出血并发症的发生率，并确定该患者亚组的危险因素。在 106 例接受择期开颅手术的脑膜瘤患者中，有 5.7%（6 例）出现症状性 VTE。对于危险因素分析，年龄较大（57.20±11.60 岁比 71.00±0.90 岁，p<0.001）、体质量指数较高（27.60±4.80 千克/平方米比 33.16±0.60 千克/平方米，p<0.001）、世界卫生组织分级 II 级（3.00%比 33.33%，p=0.02）、术中出血量较少（466.00±383.70 毫升比 216.70±68.30 毫升，p<0.001）、卧床和神经功能缺损状态（0.00%比 33.33%，p=0.003 和 38.00%比 100.00%，p=0.004）与 VTE 风险增加相关。单因素分析未发现出血并发症的危险因素。总之，脑膜瘤患者 VTE 的发生率不可忽视。在降低出血风险的情况下，应考虑到确定的危险因素，以便在决策过程中决定是否进行化学预防。
