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JOURNAL TITLE: Journal of Postgraduate Medicine, Education and Research
Patients undergoing surgery for intracranial tumors are at significant risk of developing deep venous thrombosis (DVT) due to postoperative immobilization. The role of heparin prophylaxis in preventing this complication and the risk of intracranial hemorrhagic complications due to anticoagulation is not well established. The present study was designed to address this issue.
A prospective randomized study was conducted to include 100 patients who were undergoing surgery for intracranial tumors. Patients who were immobilized in bed for more than 48 hours after surgery were included. The patients were categorized into two groups depending upon whether they received heparin prophylaxis or not. Further each group was subdivided into two based upon the duration of surgery: Less than or more than 3 hours. The incidence of DVT and of postoperative hemorrhagic complications was studied in all the groups. Various demographic as well as risk factors were analyzed to assess their impact on the incidence of DVT.
Overall incidence of DVT was 17%. Incidence of DVT was 12% in patients who received heparin as compared to 22% who did not. However, this difference did not reach statistical significance. The incidence was almost double when the duration of surgery was more than 3 hours. Patients with 2 or more risk factors had an increased frequency of DVT. One patient in the heparin positive group died as a result of postoperative hemorrhagic complication.
The incidence of DVT was found to be numerically lower in patients who received postoperative heparin as well as in patients in whom the duration of surgery was less than 3 hours.
Singla N, Bendapudi DP, Chhabra R, Malhotra P, Prakash M, Gupta SK. A Prospective Randomized Controlled Study of the Role of Heparin in Preventing Deep Venous Thrombosis in Postoperative Craniotomy Patients. J Postgrad Med Edu Res 2013;47(3):131-137.
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