Case-control study for risk factors of venous thromboembolism in neurosurgical and spinal surgery patients in Chiangrai Prachanukroh Hospital
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Abstract
BACKGROUND: Venous thromboembolism (VTE) is a prevalent complication in neurosurgical patients, potentially resulting in significant morbidity or sudden death. Early intervention is essential in reducing the adverse effects of this condition.
OBJECTIVE: This study aims to identify the risk factors associated with VTE, encompassing preoperative, intraoperative, and postoperative factors, to utilize the study findings in effective preventive strategies.
METHODS: A total of 525 patients aged 18 years or older, who underwent neurosurgical or spinal procedures at Chiangrai Prachanukroh Hospital between January 1, 2010, and December 31, 2024, were included. A case-control study design was employed, comparing patients diagnosed with VTE to those without VTE. The variables analyzed included demographic data, comorbidities and surgical-related factors such as the duration of the operation and length of hospital stay. Data was extracted from the hospital’s electronic medical records for analysis.
RESULTS: Among the 525 patients, 25 (4.8%) developed VTE. Multivariate logistic regression analysis identified several significant risk factors for VTE, including female gender (aOR 3.24, 95% CI 1.25-8.43, p=0.016), diabetes mellitus (OR 3.10, 95% CI 1.14-8.46, p=0.027), cancer (OR 7.35, 95% CI 1.84-29.43, p=0.005), length of hospital stay per day (OR 1.04, 95% CI 1.02-1.06, p=0.001) and increase in Caprini risk score per category (OR 2.79, 95% CI 1.45-5.35, p=0.002).
CONCLUSIONS AND RECOMMENDATIONS: The study concludes that female gender, diabetes mellitus, cancer, longer hospital stays and higher Caprini risk score categories are significant risk factors for VTE in patients undergoing neurosurgical and spinal procedures. It is recommended that targeted preventive strategies and enhanced monitoring protocols be implemented to reduce the risk of VTE in this population.
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