J Neurol Surg B
DOI: 10.1055/s-0039-3400223
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Postoperative Venous Thromboembolism after Neurotologic Surgery

Noor-E-Seher Ali
1  Department of Otolaryngology, Stanford University, Stanford, California, United States
,
Jennifer C. Alyono
1  Department of Otolaryngology, Stanford University, Stanford, California, United States
,
Yohan Song
1  Department of Otolaryngology, Stanford University, Stanford, California, United States
,
Ali Kouhi
1  Department of Otolaryngology, Stanford University, Stanford, California, United States
,
Nikolas H. Blevins
1  Department of Otolaryngology, Stanford University, Stanford, California, United States
› Author Affiliations
Further Information

Publication History

17 May 2019

28 September 2019

Publication Date:
14 November 2019 (online)

Abstract

Objective This study aimed to determine the incidence of postoperative venous thromboembolism (VTE) in adults undergoing neurotologic surgery at a single center.

Methods The records of adults undergoing neurotologic surgery from August 2009 to December 2016 at a tertiary care hospital were reviewed for VTE within 30 postoperative days. Particular attention was focused on postoperative diagnosis codes, imaging, and a keyword search of postoperative notes. Caprini risk scores were calculated.

Results Among 387 patients, 5 experienced postoperative VTE including 3 cases of pulmonary embolism (PE) and 2 cases of isolated deep vein thrombosis (DVT). All patients were given sequential compression devices perioperatively, and none received preoperative chemoprophylaxis. Patients with Caprini score > 8 had a significantly higher rate of VTE compared with those < 8 (12.5 vs. 1%, p = 0.004). Receiver operating characteristic analysis revealed the Caprini risk assessment model to be a fair predictor of VTE, with a C-statistic of 0.70 (95% confidence interval [CI]: 0.49–0.92).

Conclusion While no specific validated VTE risk stratification scheme has been widely accepted for patients undergoing neurotologic surgery, the Caprini score appears to be a useful predictor of risk. The benefits of chemoprophylaxis should be balanced with the risks of intraoperative bleeding, as well as the potential for postoperative intracranial hemorrhage.