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62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

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High activity and substitution of factor XIII increase the risk of pulmonary embolism during meningioma surgery

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  • S. Grau - Neurochirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilian-Universität München; Zentrum für Neurochirurgie, Klinikum der Universität zu Köln, Köln
  • F.W. Kreth - Neurochirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilian-Universität München
  • V. Huge - Klinik für Anaesthesiologie, Klinikum Grosshadern, Ludwig-Maximilian-Universität München
  • A. Meyer-Bender - Klinik für Anaesthesiologie, Klinikum Grosshadern, Ludwig-Maximilian-Universität München
  • D. Morhard - Abteilung für Klinische Chemie, Klinikum Grosshadern, Ludwig-Maximilian-Universität München
  • P. Goehring - Abteilung für Radiologie, Klinikum Grosshadern, Ludwig-Maximilian-Universität München
  • I. Krotofil - Neurochirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilian-Universität München
  • J.C. Tonn - Neurochirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilian-Universität München

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMI.04.08

doi: 10.3205/11dgnc206, urn:nbn:de:0183-11dgnc2060

Published: April 28, 2011

© 2011 Grau et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: This study was conducted to evaluate the incidence of pulmonary embolism after meningioma surgery and to determine the risk factors including the role of factor XIII.

Methods: 410 consecutive patients were enrolled in this pro- and retrospective cohort study. Activity levels of factor XIII together with standard coagulation parameters as well as surgery-related parameters were monitored.

Results: Pulmonary embolism (assessed using pulmonal angiography by computed tomography) occurred in 33 (8.0%) of 410 cases. Patients with embolism had longer surgery (p = 0.036), higher preoperative factor XIII activity (p = 0.022) or had received factor XIII substitution by the end of surgery (p = 0.001). In multivariate analysis gender, duration of surgery, preoperative factor XIII activity as well as factor XIII substitution remained significant prognostic factors for the development of pulmonary embolism. Relative risk of pulmonary embolism for patients with preoperative factor XIII activity >120% was 2.0 (95% CI 1.53–2.7) which was increased to 2.4 (95% CI 1.63–6.6) by surgery of five hours or more.

Conclusions: This is the first study demonstrating a strong impact of factor XIII activity as well as its substitution on the formation of pulmonary embolism. This underlines the complex interrelation of prophylactic measurements in order to reduce the rate of postoperative haemorrhage and pulmonary embolism after meningioma surgery.