Journal des soins intensifs et critiques Libre accès

Abstrait

Bleeding Risk and Thromboprophylaxis in Neurosurgical Patients after Emergency Procedures

Joaquin Cagliani, Garry Ritter, Chris Nelson, Denis Knobel, Kristen Hopkins, Ernesto P Molmenti, Jeffrey Nicastro, Gene Coppa and Rafael Barrera

Purpose: We aimed to evaluate its safety in the emergency neurosurgicalpopulation at a tertiary hospital center.

Methods: Retrospective analyses of prospectively-collected data were performed on patients ad-mitted to the surgical intensive care unit (SICU) after emergency neurosurgical procedure. We examined patient demographic and clinical information, survival outcomes, and rates of heparin induced thrombocytopenia and pulmonary embolism in patients who received subcutaneous unfractionated heparin (SCUFH) compared to those who did not.

Results: We identified 223 emergency neurosurgical patients, of which 100 received no anticoagulation (44.84%) and 123 received SCUFH (55.16%). In the SCUFH group, 88 patients received chemoprophylaxis within 24 h and 35 after 24 h. A statistically significant difference was noted with the admission APACHE II score of patients receiving SCUFH to those who did not, but APACHE III and SAPS on admission were shown to have no difference in outcome.

Conclusion: Administration of SCUFH in the emergency neurosurgical population does not increase the risk of bleeding post-operatively and continues to be a safe and effective chemoprophylaxis agent against VTE.