Deep Vein Thrombosis and the Neurosurgical Patient

| Posted in: Science

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Deep Vein Thrombosis and the Neurosurgical Patient
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Rakesh Rethinasamy, Azmi Alias, Regunath Kandasamy, Azman Raffiq, Mun Choon Looi, Tassha Hillda


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Deep Vein Thrombosis and the Neurosurgical Patient

Year: 2019 | Doi: 10.21315/mjms2019.26.5.13

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Deep vein thrombosis (DVT) poses a significant risk to neurosurgery patients, regardless of whether they are admitted electively or as emergencies. In this study, researchers aimed to identify factors associated with DVT occurrence in neurosurgical patients at Kuala Lumpur Hospital over a year-long timeframe. They utilized D-dimer screening and ultrasound Doppler as diagnostic tools. Additionally, the study sought to evaluate the applicability of the Well's Score for DVT risk assessment in their local cohort while comparing their findings against other studies that employed more aggressive pharmacological prophylaxis.

The Role of Well's Score in DVT Risk Assessment

The study emphasized the significance of the Well's Score as a predictive factor for DVT development. Among 320 eligible patients analyzed, the results indicated that a higher Well's Score increased the risk of DVT by a notable factor of 7.2 when adjusted for various demographic and clinical variables. Furthermore, the number of days patients spent in bed post-surgery emerged as an independent risk factor, with each additional day correlating with a rise in DVT odds. Despite the prevalent use of mainly mechanical prophylaxis methods in the cohort, the incidence of DVT was comparable to other centers utilizing dual-modality prophylaxis, indicating that single-modality methods could be sufficient for many patients.

Conclusion

Overall, this study concluded that the Well's Score and the duration of bed rest are critical determinants of DVT risk in neurosurgical patients. While the institution primarily used mechanical prophylaxis, the observed DVT rates align with existing literature. The findings advocate for the standard implementation of Well's Score in clinical assessments within neurosurgery units to better identify high-risk patients, thus allowing for tailored prophylaxis strategies that consider both benefits and risks of pharmacological interventions. Through diligent assessment and management, the incidence of DVT can be effectively monitored and potentially reduced among neurosurgical patients.

FAQ section (important questions/answers):

What is the focus of the study on neurosurgical patients?

The study aims to identify factors associated with deep vein thrombosis (DVT) among neurosurgical patients and the incidence rate of DVT at the research center.

How was DVT screened in the study participants?

Patients underwent D-dimer screening three days post-surgery; those with positive results were then assessed using ultrasound Doppler to diagnose any potential DVT.

What were the significant predictors of DVT identified in the study?

The study found that the Well’s score and the number of days in bed were significant independent predictors of developing DVT among neurosurgical patients.

What was the reported incidence rate of DVT in this study?

The study reported an overall DVT incidence rate of 10.3% among the neurosurgical patients, comparable to rates seen in other centers utilizing dual prophylaxis methods.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Deep Vein Thrombosis and the Neurosurgical Patient”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Study (Studying):
The term 'Study' refers to the systematic investigation into the incidence of deep vein thrombosis (DVT) among neurosurgical patients. It highlights the significance of research in understanding DVT's risk factors, promoting evidence-based practices, and improving the safety and outcomes for patients after surgery, making it vital in clinical settings.

2) Table:
The word 'Table' signifies the organized presentation of data and findings within the research document. It includes patient demographics and DVT statistics, facilitating easy comparisons and understanding of results, crucial for readers and clinicians who seek to discern patterns and make informed decisions based on the presented data.

3) Developing:
The word 'Developing' emphasizes the processes that lead to the formation of deep vein thrombosis in patients. Understanding how DVT arises involves examining risk factors, physical conditions, and patient management strategies, thereby aiding healthcare providers in implementing preventative measures and improving patient care and outcomes within neurosurgical environments.

4) Observation:
Observation indicates the careful monitoring and assessment of patients for signs of DVT, such as swelling or pain. This practice is essential in clinical settings to ensure early detection and management of potential complications, significantly impacting patient safety and recovery trajectories following neurosurgical interventions and highlighting the importance of vigilance in patient care.

5) Male:
The term 'Male' refers to a demographic characteristic within the study population, indicating that a substantial portion of the patients analyzed were male. This gender-related aspect is relevant for understanding epidemiological trends, risk factors, and tailoring preventive strategies in the context of DVT and neurosurgical care.

6) Pharmacological:
Pharmacological refers to the use of medication in the prevention and treatment of DVT. In the study, the discussion of pharmacological prophylaxis highlights the complexities and risks involved in using anticoagulants for neurosurgical patients, stressing the need for cautious application amidst concerns about bleeding and other adverse effects.

7) Disease:
The term 'Disease' refers to deep vein thrombosis (DVT) as a medical condition that can lead to serious complications. Understanding DVT as a disease includes evaluating risk factors, such as surgery and immobility, and underscores the importance of prevention and timely intervention to enhance patient outcomes in neurosurgical contexts.

8) Indian:
The word 'Indian' identifies a specific ethnic group represented in the study's patient demographics, contributing to the awareness of potential ethnic variations in disease prevalence and risk factors. This information is vital for tailoring medical treatments and preventive measures to address the unique needs of diverse populations in clinical practice.

9) Rules:
The term 'Rules' relates to clinical guidelines and protocols established for managing DVT in patients. These rules shape the practices that neurosurgeons follow regarding pharmacological and mechanical prophylaxis, emphasizing the need for adherence to evidence-based practices to mitigate risks associated with surgical procedures and patient care.

10) Performance:
Performance refers to the efficacy of assessments, such as the Well's score, in identifying DVT risk factors. Understanding how well these tools perform highlights their relevance and utility in clinical settings, enhancing the ability of healthcare providers to apply appropriate prophylaxis strategies tailored to individual patient profiles.

11) Swelling:
Swelling is a clinical sign that may indicate the presence of DVT in patients. Recognizing swelling, particularly in unilateral cases, guides clinicians in their decision-making processes regarding further diagnostics, such as ultrasound, helping facilitate early intervention and management strategies crucial for preventing severe complications in neurosurgical patients.

12) Family:
The term 'Family' emphasizes the role of relatives in providing health histories and supporting patients. As some patients may be unable to communicate effectively, family involvement becomes crucial in gathering information about risk factors, symptoms, and medical history, thereby enhancing the quality of care delivered in clinical settings.

13) Cancer:
The word 'Cancer' in the context of this study underscores its association with an increased risk of developing DVT. Recognizing cancer as a significant risk factor informs healthcare decisions and management strategies for neurosurgical patients, highlighting the importance of vigilance and tailored prophylactic measures in this specific patient population.

14) India:
India refers to the geographical and cultural setting of the study, contributing to the demographic profile of the patient population analyzed. This context may influence the study's findings regarding DVT prevalence and risk factors, facilitating better understanding and engagement in localized healthcare practices and policies associated with neurosurgical interventions.

15) Roman (Roma):
The term 'Roman' may refer to the systematic way of documenting and structuring findings within the study. It implies an organized approach in presenting research methods and results, which is critical for readers, researchers, and practitioners to understand the work's significance and how it contributes to medical knowledge.

16) Blood:
The word 'Blood' refers to its critical role in the context of DVT, as blood clots form within the venous system leading to the condition. Understanding blood dynamics, coagulation, and factors affecting circulation informs clinicians about the importance of prevention strategies, ensuring better management of patients at high risk for thrombosis.

17) Life:
The term 'Life' captures the overarching goal of medical interventions, including DVT prevention. Enhancing the quality and longevity of life for surgical patients remains a central focus for healthcare providers. Effective management of DVT risk factors plays a crucial role in achieving favorable outcomes and a better quality of life post-surgery.

18) Discussion:
Discussion pertains to the section where researchers interpret their findings in the context of existing literature. This segment provides insights into the implications of the study's outcomes, enhances understanding of DVT in neurosurgical patients, and facilitates ongoing conversations regarding best practices, prevention strategies, and future research directions.

19) Training:
The word 'Training' emphasizes the importance of educating medical staff about the best practices for DVT prevention and management. Ongoing professional training and updates on clinical guidelines ensure that healthcare providers remain well-informed about evolving strategies in managing patient care effectively, particularly in high-risk populations in surgical settings.

20) Science (Scientific):
The term 'Science' reflects the systematic study of phenomena, including health and disease processes like DVT. It emphasizes the foundational principles that guide research methodologies, data analysis, and evidence-based practices, underscoring the critical role of scientific inquiry in informing clinical decision-making and optimizing patient care.

21) Nature:
Nature refers to the intrinsic characteristics and behaviors of patients, including biological and environmental factors contributing to DVT risk. Understanding the nature of individual patient profiles enhances clinicians' ability to tailor prophylactic measures and patient education, emphasizing personalized medicine's role in addressing specific needs and improving outcomes.

22) Reason:
Reason signifies the logical processes involved in identifying causative factors and justifying healthcare practices. It underscores the necessity of understanding why certain patient characteristics influence DVT risk, directing healthcare providers towards effective interventions and decision-making based on patient-specific data and established clinical guidelines.

23) Malin:
Malin may refer to Dr. Malin Abdullah, whose involvement in the training program signifies mentorship and support for new medical professionals. His role exemplifies the importance of experienced guidance in fostering knowledge, skills, and professional development for healthcare workers engaged in research and patient care.

24) Death:
The term 'Death' indicates the potential severity of complications arising from untreated DVT, such as pulmonary embolism. This association emphasizes the importance of prevention, early detection, and management of DVT in clinical practice, as failure to address it adequately may result in life-threatening consequences for neurosurgical patients.

25) Musha (Musa, Musá):
Musa likely refers to Dr. Kamarul Imran Musa, whose contributions as a public health physician are vital in the research context. His role emphasizes the collaborative approach necessary in studying health issues like DVT and highlights the intersection of clinical practice and public health in improving patient outcomes.

26) Pain:
The word 'Pain' is indicative of a clinical symptom that may provoke therapeutic intervention or further diagnostic investigation for DVT. Recognizing pain as a symptom enables healthcare providers to make timely decisions regarding patient evaluation and subsequent management strategies aimed at preventing severe complications associated with DVT.

27) Post:
Post refers to the period following neurosurgical procedures when patients are at particular risk for conditions like DVT. Analyzing post-operative outcomes and patient care strategies is crucial for enhancing recovery, ensuring patient safety, and implementing effective prophylaxis measures to mitigate DVT-related complications.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Deep Vein Thrombosis and the Neurosurgical Patient’. Further sources in the context of Science might help you critically compare this page with similair documents:

Moral support, Data collection, Conflict of interest, Data analysis, Medical research, Statistical Significance, Multivariate analysis, Ethics committee, Clinical tool, Surgical Procedure, Deep vein thrombosis, Non-probability sampling, D-dimer, Compression stocking, Risk factor, Ambulatory Patient, Pulmonary embolism, Wells Score, Anticoagulant therapy, Hospital setting, Brain tumor, Risk stratification, Traumatic brain injury, Low molecular weight heparin, Venous thromboembolism, Biostatistician, Neurosurgical patients, Deep venous thrombosis, Blood clot, Author contributions, Trauma Patients, Pharmacological prophylaxis, Ethical standard, Brain tumour, DVT, Brain injury, Blood vessel, Authors contribution, Study material.

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