ArticlePloS one2020
Perioperative anticoagulation in patients with intracranial meningioma: No increased risk of intracranial hemorrhage?
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- Predictors of Postoperative Bleeding After Cranial Surgery: The Role of Perioperative and Tumor-Related Factors.Current oncology (Toronto, Ont.) · 2025Article
- The Influence of Demographic Characteristics, Pre-Existing Conditions and Laboratory Parameters on Postoperative Hemorrhage After Brain Tumor Surgery.Life (Basel, Switzerland) · 2025Article
- Prophylactic anticoagulation in traumatic subdural hematoma.Scientific reports · 2025Article
- Venous thromboembolism and intracranial hemorrhage in patients undergoing glioblastoma surgery.Scientific reports · 2023Article
- Meningioma resection and venous thromboembolism incidence, management, and outcomes.Research and practice in thrombosis and haemostasis · 2023Article
- The role of extended coagulation screening in adult cranial neurosurgery.Brain & spine · 2023Article
- Preoperative prediction of Ki-67 and p53 status in meningioma using a multiparametric MRI-based clinical-radiomic model.Frontiers in oncology · 2023Article
- Tinzaparin vs. Nadroparin Safety and Efficacy in Neurosurgery.Neurology international · 2021Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveAnticoagulation (AC) is a critical topic in perioperative and post-bleeding management. Nevertheless, there is a lack of data about the safe, judicious use of prophylactic and therapeutic anticoagulation with regard to risk factors and the cause and modality of brain tissue damage as well as unfavorable outcomes such as postoperative hemorrhage (PH) and thromboembolic events (TE) in neurosurgical patients. We therefore present retrospective data on perioperative anticoagulation in meningioma surgery.
methodsData of 286 patients undergoing meningioma surgery between 2006 and 2018 were analyzed. We followed up on anticoagulation management, doses and time points of first application, laboratory values, and adverse events such as PH and TE. Pre-existing medication and hemostatic conditions were evaluated. The time course of patients was measured as overall survival, readmission within 30 days after surgery, as well as Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS). Statistical analysis was performed using multivariate regression.
resultsWe carried out AC with Fraxiparin and, starting in 2015, Tinzaparin in weight-adapted recommended prophylactic doses. Delayed (216 ± 228h) AC was associated with a significantly increased rate of TE (p = 0.026). Early (29 ± 21.9h) prophylactic AC, on the other hand, did not increase the risk of PH. We identified additional risk factors for PH, such as blood pressure maxima, steroid treatment, and increased white blood cell count. Patients' outcome was affected more adversely by TE than PH (+3 points in modified Rankin Scale in TE vs. +1 point in PH, p = 0.001).
conclusionEarly prophylactic AC is not associated with an increased rate of PH. The risks of TE seem to outweigh those of PH. Early postoperative prophylactic AC in patients undergoing intracranial meningioma resection should be considered.
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