Perioperative deep venous thrombosis prophylaxis in patients with glioblastoma: a propensity score-matched comparative study

To investigate the effectiveness and safety of perioperative prophylaxis protocol for deep venous thrombosis (DVT) in patients undergoing surgery for treating glioblastoma. A total of 428 patients were prospectively enrolled to undergo preoperative risk assessment, postoperative dynamic screening and prophylactic anticoagulation for DVT in the lower extremities. A 1:1 propensity-score matching was retrospectively performed to select controls who were hospitalized at the same time without perioperative DVT prophylaxis. Primary endpoint was the incidence of postoperative DVT during hospitalization. Secondary outcomes included pulmonary embolism (PE), length of hospital stay (LOS), delays in adjunctive chemoradiotherapy (CRT) and quality-adjusted life years (QALYs) within 3 months after discharge. Postoperative DVT occurred in 7.0% of patients in the screening cohort, which was significantly lower than the 22.2% observed in the matched controls, showing a difference of 15.2% (95%CI: 10.6%, 19.8%). Fewer patients in the screening cohort experienced postoperative PE compared to controls (p = 0.018). The rates of major and minor bleeding events following pharmacological prophylaxis were similar between the two cohorts (both p > 0.05). Patients with DVT screening were associated with shorter LOS, lower rates of delayed CRT and higher QALYs scores at both 1- and 3-month follow-up visits. No deaths were observed in either cohort during hospitalization. This perioperative prophylaxis protocol was more effective at detecting postoperative DVT, without increasing the risk of major bleedings after surgery. This benefit was associated with a significantly shorter LOS, a lower rate of delayed CRT and improved QALYs scores within a 3-month follow-up period.