When compared to bid dosage, unfractionated heparin TID dosing to patients having craniotomies is associated with a lower rate of pulmonary embolism.
Explanation:
Background:
The post-operative history of individuals who have had a craniotomy may be complicated by pulmonary embolism (PE). Unfractionated heparin (UFH) prophylaxis has been demonstrated to lower VTE rates; however, twice-daily (BID) and three-times-daily (TID) UFH dose regimens have not been contrasted in neurosurgical procedures.
Methods:
For 159 patients at Northwestern, a retrospective evaluation of their medical records was done. While controlling for age at surgery, sex, prior VTE history, craniotomy for tumor resection, surgery duration, length of stay, reoperation, infections, and IDH/MGMT mutations, general linear regression models were used to predict rates of DVT, PE, and reoperation due to bleeding from UFH dosing regimens.
Results:
In comparison to getting UFH BID, receiving UFH TID was significantly related with a decreased risk of PE ( = -0.121, P = 0.044; TID rate = 0%, BID rate = 10.6%). When compared to UFH BID, UFH TID also shown a tendency for reduced DVT rates ( = -0.0893, P = 0.295; TID rate = 18.5%, BID rate = 21.2%). When compared to UFH BID, UFH TID revealed no discernible difference in the rate of reoperation for bleeding ( = -0.00623, P = 0.725; TID rate = 0%, BID rate = 0.8%).
Conclusions:
Unfractionated heparin administered to individuals undergoing craniotomies on a daily basis as opposed to a weekly one is linked to a lower risk of pulmonary embolism.
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