Artikel
Perioperative management to reduce pulmonary embolism after meningioma resection
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Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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Objective: Among all intracranial tumours, meningiomas show the highest rate of postoperative pulmonary embolisms. Preventive measures including compression stockings, early mobilisation and the administration of heparin are thought to lower morbidity, but the usefulness of these measures needs quantification.
Methods: In an observational study, we retrospectively reviewed all patients who were operated on for meningioma in our clinic between 1999 and 2010. Only patients with a follow-up of 3 months were included. The prevention scheme was changed in 2007. We compared patients treated before 2007 with patients treated after 2007 using logistic regression to adjust for confounding factors related to pulmonary embolism incidence.
Results: In the patient group treated before 2007 there were 420 cases including 159 meningiomas of the cranial base; after 2007 there were 228 cases including 77 at the cranial base. In the new prevention scheme, the incidence of pulmonary embolism was significantly reduced from 6.8% to 1.6% (p=0.001). The risk of pulmonary embolism was associated with the number of days spent in the clinic, the BMI and the cranial base localisation of the tumour.
Conclusions: In our study, the new prevention scheme leads to a significant decrease in the incidence of pulmonary embolisms. We assume that the early administration of Heparin and the perioperative use of compression stockings are the most important elements lowering morbidity.