Yan Kaixuan, Yan Pengfei, Cao Lujie, Su Jing, Zhang Qingqing, Zhang Liting, Jiang Xiaobin
Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, P.R. China.
Department of Medical Records and Statistics, The First People's Hospital of Jiangxia District, Wuhan, 430022, Hubei, P.R. China.
Neurosurg Rev. 2025 Mar 3;48(1):280. doi: 10.1007/s10143-025-03409-0.
Neurosurgery patients are at high risk of developing venous thromboembolism (VTE) which increases the risk of morbidity and mortality. This study is designed to investigate the effectiveness and safety of sulodexide in combination with routine VTE prophylaxis compared with routine VTE prophylaxis alone for VTE prevention in neurosurgical patients. This retrospective, cohort study included neurosurgical patients received routine VTE prophylaxis (control group) or routine VTE prophylaxis plus sulodexide (experimental group) during hospitalization. Predictors of VTE during hospitalization were determined using multivariable logistic regression. A total of 694 eligible patients were included in this study. The incidence of VTE in the experimental group (4.52%, 10/221) was lower compared with that in the control group (6.98%, 33/473) (P = 0.212). The change from baseline in serum creatinine and blood urea nitrogen of the experimental group was significantly higher compared with that in the control group (both P < 0.05). In elderly patients (>65 years), VTE incidence in the experimental group was 3.51% which was significantly lower than that in the control group (10.8%; P = 0.03) and odd ratio [OR] was 0.3 (95% confidence interval [CI]: 0.07, 0.92). Multivariate logistic regression analysis revealed that use of sulodexide plus routine VTE prophylaxis (OR = 0.172, 95% CI: 0.055, 0.535; P = 0.006) and baseline Glasgow Coma Scale (GCS) score (OR = 0.587, 95% CI: 0.521, 0.792; P < 0.001) were protective factors for VTE risk, and the length of hospital stay (OR = 1.134, 95% CI: 1.021, 1.199; P=0.007) was a risk factor for VTE. Sulodexide in combination with routine VTE prophylaxis effectively reduces the risk of VTE in neurosurgical patients. A high baseline GCS score is a protective factor for VTE, whereas length of hospital stay is a risk factor for VTE.
神经外科患者发生静脉血栓栓塞症（VTE）的风险很高，这会增加发病和死亡风险。本研究旨在调查舒洛地昔联合常规VTE预防措施与单纯常规VTE预防措施相比，在预防神经外科患者VTE方面的有效性和安全性。这项回顾性队列研究纳入了住院期间接受常规VTE预防措施的神经外科患者（对照组）或常规VTE预防措施加舒洛地昔的患者（试验组）。使用多变量逻辑回归确定住院期间VTE的预测因素。本研究共纳入694例符合条件的患者。试验组的VTE发生率（4.52%，10/221）低于对照组（6.98%，33/473）（P = 0.212）。试验组血清肌酐和血尿素氮相对于基线的变化显著高于对照组（均P < 0.05）。在老年患者（>65岁）中，试验组的VTE发生率为3.51%，显著低于对照组（10.8%；P = 0.03），比值比[OR]为0.3（95%置信区间[CI]：0.07，0.92）。多变量逻辑回归分析显示，使用舒洛地昔加常规VTE预防措施（OR = 0.172，95% CI：0.055，0.535；P = 0.006）和基线格拉斯哥昏迷量表（GCS）评分（OR = 0.587，95% CI：0.521，0.792；P < 0.001）是VTE风险的保护因素，而住院时间（OR = 1.134，95% CI：1.021，1.199；P = 0.007）是VTE的风险因素。舒洛地昔联合常规VTE预防措施可有效降低神经外科患者发生VTE的风险。较高的基线GCS评分是VTE的保护因素，而住院时间是VTE的风险因素。
