Rate of Development of Venous Thromboembolism in Lateral Skull Base Surgery.
OBJECTIVES: Venous thromboembolism (VTE) is a major cause of morbidity and mortality for surgical patients. This article aims to determine factors that may have contributed to the development of VTE in patients undergoing lateral skull base surgery, to assess the validity of the Caprini Risk Assessment Model (RAM) score in this subset of patients, and to determine the efficacy of mechanical DVT prophylaxis alone in preventing VTE.
STUDY DESIGN: Retrospective chart review.
METHODS: A retrospective chart review was conducted of patients who underwent skull base surgery for vestibular schwannoma, and the rate of VTE was assessed. Patient demographics, comorbidities, and treatment factors were examined to determine risk factors associated with the development of a postoperative thrombotic event. Caprini RAM scores were compared for patients who developed a VTE.
RESULTS: Among 197 patients, the rate of VTE formation was 3.5%. No individual risk factor independently contributed to the development of a thrombotic event. The mean Caprini RAM score was 4.06 in patients who did not develop a VTE and 5.14 in the patients that did develop a VTE (P = .005). The Caprini score was significant for the risk of VTE formation, with an odds ratio of 2.8 (P = .009, 95% CI = 1.3-6.2).
CONCLUSION: Venous thromboembolism rates are relatively low following lateral skull base surgery. While there is no individual risk factor associated with increased VTE risk, the Caprini RAM score appears to be a useful predictor of risk. The Caprini score may be useful in identifying high-risk patients who may benefit from chemoprophylaxis for VTE prevention.
LEVEL OF EVIDENCE: 3 Laryngoscope, 132:662-667, 2022.
Anderson BP, Sioshansi PC, Conway RM, Minutello K, Bojrab DI, Hong RS, et al [Sargent EW, Schutt CA, Bojrab DI 2nd, Zappia JJ, Babu SC] Rate of development of venous thromboembolism in lateral skull base surgery. Laryngoscope. 2022 Mar;132(3):662-667. doi: 10.1002/lary.29889. PMID: 34633085.