Xiaopeng Guo1, Fa Zhang2, Yue Wu3, Lu Gao1, Qiang Wang1, Zihao Wang1, Chenzhe Feng1, Yi Yang1, Bing Xing1, Zhiqin Xu4. 1. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 2. Peking Union Medical College, Beijing, China. 3. Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 4. Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: xuzhq1999@126.com.
Abstract
OBJECTIVE: To explore coagulation function in patients with brain tumors before and after craniotomy and tumor resection and to analyze its correlation with deep vein thrombosis (DVT). METHODS: This study enrolled 133 consecutive patients with brain tumors. Coagulation evaluation and limb venous ultrasonography were performed before and after surgery. Clinical characteristics and dynamic changes in coagulation parameters were recorded, and their correlations with DVT were analyzed. RESULTS: The incidence of postoperative DVT in patients with brain tumors was 10.5%. The average age of patients with DVT was older compared with patients without DVT (63.21 ± 11.21 years vs. 50.24 ± 11.95 years, P < 0.001), and the incidence of hepatitis B (21% vs. 4%, P = 0.035) was higher in patients with DVT compared with patients without DVT. D-dimer and fibrinogen were the most variable parameters during the perioperative period. In patients with DVT, D-dimer levels displayed a "zigzagging-rise" trend and were significantly higher than levels in patients without DVT. Platelet levels displayed a "first-descend-then-rise" trend and were significantly lower in patients with DVT on the second and third postoperative days. CONCLUSIONS: In patients with brain tumors, D-dimer and fibrinogen were elevated postoperatively, manifesting as hypercoagulability. Postoperative DVT was correlated with aging and hepatitis B. A "zigzagging-rise" trend of D-dimer and a "sharp-descent" trend of platelets in the early postoperative period might predict DVT in patients with brain tumors.
OBJECTIVE: To explore coagulation function in patients with brain tumors before and after craniotomy and tumor resection and to analyze its correlation with deep vein thrombosis (DVT). METHODS: This study enrolled 133 consecutive patients with brain tumors. Coagulation evaluation and limb venous ultrasonography were performed before and after surgery. Clinical characteristics and dynamic changes in coagulation parameters were recorded, and their correlations with DVT were analyzed. RESULTS: The incidence of postoperative DVT in patients with brain tumors was 10.5%. The average age of patients with DVT was older compared with patients without DVT (63.21 ± 11.21 years vs. 50.24 ± 11.95 years, P < 0.001), and the incidence of hepatitis B (21% vs. 4%, P = 0.035) was higher in patients with DVT compared with patients without DVT. D-dimer and fibrinogen were the most variable parameters during the perioperative period. In patients with DVT, D-dimer levels displayed a "zigzagging-rise" trend and were significantly higher than levels in patients without DVT. Platelet levels displayed a "first-descend-then-rise" trend and were significantly lower in patients with DVT on the second and third postoperative days. CONCLUSIONS: In patients with brain tumors, D-dimer and fibrinogen were elevated postoperatively, manifesting as hypercoagulability. Postoperative DVT was correlated with aging and hepatitis B. A "zigzagging-rise" trend of D-dimer and a "sharp-descent" trend of platelets in the early postoperative period might predict DVT in patients with brain tumors.
Authors: Lorenzo Rinaldo; Desmond A Brown; Adip G Bhargav; Aaron E Rusheen; Ryan M Naylor; Hannah E Gilder; Dileep D Monie; Stephanie J Youssef; Ian F Parney Journal: J Neurosurg Date: 2019-01-04 Impact factor: 5.115