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.
Keywords
venous thromboembolism - deep venous thrombosis - pulmonary embolism - neurotologic
surgery - Caprini score
