| Background and purpose: Deep venous thrombosis is a common vascular disease that can cause serious clinical consequences.Neurosurgical patients,especially those with intracranial tumors,are at high risk of deep venous thrombosis and should receive more attention.The purpose of this study was to investigate the incidence of perioperative deep venous thrombosis in patients with intracranial tumor resection and to analyze risk factors associated with deep venous thrombosis in lower extremities.Subjects and method: This study is an observational study.It was recruited in the neuro-oncology surgery of the First Hospital of Jilin University from May 2018 to January 2019.The clinical diagnosis was intracranial tumor,and who underwent intracranial tumor resection were enrolled.The study collected and recorded all subjects’ age,gender,smoking history,drinking history,history of hypertension,history of diabetes,WHO classification of intracranial tumor,body mass index,blood type,blood lipids(cholesterol,triglycerides,low density lipoprotein cholesterin,density lipoprotein cholesterin),operative time,postoperative in-bed time,postoperative muscle strength of lower limb,postoperative dehydration,postoperative glucocorticoids,postoperative lumbar drainage tube,postoperative cranial Intra-infection,post-operative venous color Doppler ultrasound results on seventh day after surgery,and plasma D-dimer results before surgery,on the first postoperative day,on the third postoperative day,and on the seventh postoperative day.Statistical analysis was performed on the collected data.Results:The present study totally enrolled 130 patients.The overall incidence of perioperative lower extremity DVT in patients after intracranial tumor resection was 18.46%(95% CI: 11.70-25.22%).There were no significant differences in the gender,WHO classification of tumor,hypertension history,diabetes history,smoking history,drinking history,and other parameters between the with-lower extremity DVT group and without-lower extremity DVT group.There were significantly difference in age,postoperative in-bed time,postoperative lower limb muscle strength,operative time and D-dimer at the third and the seventh day after surgery.The block analysis showed that the incidence of lower extremity DVT increased with age(P value for trend <0.001),and with the increase of BMI,the incidence of lower extremity DVT showed an upward trend(P value for trend = 0.033).With the increase of postoperative in-bed time,the incidence of lower extremity DVT showed an upward trend(P value for trend = 0.026).In addition,with the increase of operation time,the incidence of lower extremity DVT showed an upward trend(P value for trend = 0.008).Univariate analysis showed that age,obesity,elevated postoperative D-dimer,postoperative lower limb paralysis,and prolonged postoperative in-bed time were risk factors for perioperative lower extremity DVT in patients with intracranial tumor resection.The results of the binary logistic regression model showed that the 45-60 age group and the ≥60 age group compared with the <45 age group had a higher risk of DVT,increasing by 10.084 times and 9.882 times,respectively.People with obesity had a higher risk of developing lower extremity DVT with an increased risk of 2.919.In addition,the risk of lower extremity DVT was higher in patients with elevated D-dimer after surgery,and the risk increased by 2.415 times.People with postoperative lower limb paralysis had a higher risk of developing lower extremity DVT,and the odds ratio was 4.065.Conclusion: The overall incidence of perioperative lower extremity DVT in patients after intracranial tumor resection was as high as 18.46%(95% CI: 11.70-25.22%).The incidence of perioperative lower extremity DVT in patients after intracranial tumor resection increased with age,BMI,postoperative in-bed time and operation time.Age,obesity,elevated postoperative D-dimer,postoperative lower limb paralysis,and prolonged postoperative in-bed time were risk factors for perioperative lower extremity DVT in patients undergoing intracranial tumor resection.Age ≥ 45 years,obesity,postoperative D-dimer elevation,and postoperative lower limb paralysis are independent risk factors for perioperative lower extremity DVT in patients undergoing intracranial tumor resection. |
