Incidence of deep venous thrombosis in patients undergoing elective neurosurgery - A prospective cohort based study

The exact incidence of deep vein thrombosis (DVT) in the Indian neurosurgical patient population is uncertain. This situation is quite different from its well-documented incidence in the Caucasian population.This study aims to analyze the incidence, etiopathogenesis, and risk factors in the development of DVT in Indians. This will enable us to formulate country-specific guidelines for its appropriate and timely prophylaxis. To study the incidence of deep venous thrombosis in patients undergoing elective neurosurgery. This was a prospective cohort based study analyzing a total of 273 adult (>18 years) patients who underwent elective neurosurgery during a period of 1 year from November 2013 to December 2014.A preoperative baseline Doppler ultrasonography and coagulation profile was performed, followed by postoperative surveillance Doppler ultrasonography biweekly until discharge. Statistical analysis was performed using chi-square test and Pearson's correlation analysis. A total of 33 patients (12.08%) developed DVT in the postoperative period. Hypertension, frequent alcohol intake, smoking, and obesity were found to be the risk factors (P = 0.001). Significant association was observed between malignant tumors, meningiomas, and DVT (P = 0.001). Intraoperative supine and lateral position for more than 5 h, the severity of postoperative motor deficit, and ambulation delay of more than 2 days were significant risk factors (P = 0.001). Our study, one of the first of its kind, details the incidence and etiopathogenesis of DVT in the Indian neurosurgical population. We recommend an early usage of prophylaxis (mechanical and/or pharmacological) in the perioperative period for the high risk category of patients. We hope that this data can be used for preparing country-specific guidelines for DVT prophylaxis.