Deep vein thrombosis in a neurosurgical intensive care: An institutional experience

Abstract

Aim The aim of the following study is to study the incidence, clinical presentations, risk factors and management modalities in deep vein thrombosis (DVT) affecting patients undergoing cranial or spinal surgery in neurosurgical intensive care unit (ICU). Materials and Methods Retrospective review of patients who developed DVT in the course of prolonged ICU stay (>7 days), following cranial or spinal surgery between September 2009 and November 2011. Results A total of 260 patients were reviewed in the study period between September 2009 and November 2011. Eight patients (3.7%) were diagnosed with DVT by color Doppler during this period. The average age of the group was 47 years (range 36-70 years). 3 patients had DVT limited to the popliteal vein, 2 patients had an extension to the femoral vein and in 3 patients to the common iliac vein. Risk factors associated with DVT seen in our series included poor neurological status with immobilization in 2 patients, delayed ambulation in 3 patients, surgery in the prone position in 3 patients and old age in 1 patient. Conclusion Prolong intraoperative time; post-operative long immobilization and old age are significant contributory risk factor for DVT. However, this complication can be averted by prophylactic measures like compression stockings and intermittent compression devices used in conjunction with low molecular weight heparin and low-dose unfractionated heparin.

Keywords

• deep vein thrombosis
• heparin
• intracranial hematoma
• neurosurgical intensive care
• thromboembolism