Postoperative Hemorrhage and Venous Thromboembolism in Patients with Pituitary Adenomas Under Acetylsalicylic Acid
Abstract
:1. Introduction
2. Materials and Methods
- No ASA impact—included patients without a history of ASA use and/or those who discontinued ASA intake (ceased ≥ 7 days before surgery).
- ASA impact—included patients who continued ASA intake (<7 days before surgery, with no cessation or partial cessation).
- Hemorrhage within the tumor cavity;
- Intracerebral hemorrhage;
- Subarachnoid hemorrhage;
- Subdural hemorrhage.
Statistical Analysis
3. Results
3.1. Incidence of Intracranial Hemorrhage
3.2. Hemorrhage, Tumor Characteristics and Laboratory Parameters
3.3. Intracranial Hemorrhage Relative to ASA Impact
3.4. VTE and ASA Intake
3.5. Complication According to Ibanez Classification
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Hemorrhage with Operation | Hemorrhage Without Operation | No Hemorrhage | p-Value | ||||
---|---|---|---|---|---|---|---|
N (%) | N (%) | N (%) | |||||
ASA impact | ∑ | ||||||
Yes | 13 (12.3) | 0 (00.0) | 0 (00.0) | 13(13.0) | 0.987 | ||
No | 93 (87.7) | 2 (100.0) | 4 (100.0) | 87 (87.0) | |||
∑ (%) | 106 | 2 | 4 | 100 |
Parameters | Hemorrhage with Operation | No Hemorrhage | p-Value | ||
---|---|---|---|---|---|
N (%) | N (%) | ||||
Demographic data | |||||
Sex | Female | 0 (00.0) | 51 (50.0) | 0.495 | |
Male | 2 (100.0) | 51 (50.0) | |||
Age [Mean ± SD] | 63.0 ± 5.4 | 57.6 ± 14.6 | 0.643 | ||
Blood group | A | 1 (50.0) | 39 (40.2) | 0.915 | |
B | 0 (0.0) | 11 (11.3) | |||
AB | 0 (0.0) | 9 (9.3) | |||
O | 1 (50.0) | 38 (39.2) | |||
Smoker | Yes | 1 (50.5) | 28 (28.3) | 0.494 | |
No | 1 (50.5) | 71 (71.7) | |||
BMI [Mean ± SD] | 28.9 ± 0.5 | 29.3 ± 6.6 | 0.932 | ||
Comorbidities | |||||
Diabetes | Yes | 1 (50.0) | 17 (16.7) | 0.318 | |
No | 1 (50.0) | 85 (83.3) | |||
Hypertension | Yes | 1 (50.0) | 48 (47.1) | 0.934 | |
No | 1 (50.0) | 54 (52.9) | |||
Cardiovascular diseases | Yes | 0 (0.0) | 14 (13.7) | 0.537 | |
No | 2 (100.0) | 88 (86.3) | |||
Coagulopathy * | Yes | 0 (0.0) | 1 (1.0) | 0.888 | |
No | 2 (100.0) | 101 (99.0) | |||
Tumor characteristics | |||||
Recurrence | Yes | 0 (14.3) | 18 (17.6) | 0.514 | |
No | 2 (14.3) | 84 (82.4) |
Hemorrhage with Operation | No Hemorrhage | p-Value | ||
---|---|---|---|---|
Mean ± SD | Mean ± SD | |||
Laboratory parameters | ||||
WBC count [Gpt/L] | 9.1 ± 0.7 | 8.4 ± 2.9 | 0.390 | |
Platelet count [Gpt/L] | 263.5 ± 51.6 | 275.9 ± 107.1 | 0.949 | |
Partial thromboplastin time [s] | 28.0 ± 0.6 | 29.6 ± 6.5 | 0.632 | |
INR | 1.0 ± 0.11 | 1.0 ± 0.21 | 0.907 | |
Thrombin time [s] | 16.1 ± 0.64 | 16.6 ± 3.17 | 0.916 | |
Intraoperative characteristics | ||||
Blood loss [mL] | 450.0 ± 212 | 258.0 ± 247 | 0.207 | |
Duration of surgery [min] | 376.5 ± 231.2 | 100.6 ± 57.3 | 0.009 |
Hemorrhage with Operation | No Hemorrhage | p-Value | ||
---|---|---|---|---|
Mean ± SD | Mean ± SD | |||
Outcome patameters | ||||
Hospital stay [days] | 25.0 ± 19.8 | 12.4 ± 6.3 | 0.252 | |
Karnofsky Performance Score | 60.0 ± 28.3 | 74.3 ± 16.1 | 0.449 | |
Glasgow Outcome Scale | 3.5 ± 0.7 | 4.6 ± 0.8 | 0.037 |
Parameters | ASA Preoperatively | p-Value | |||
---|---|---|---|---|---|
No ASA Impact N 93 (%) | ASA Impact N 13 (%) | ||||
Demographic data | |||||
Sex | Female | 47 (50.5) | 6 (46.2) | 0.767 | |
Male | 46 (49.5) | 7 (53.8) | |||
Age [Mean ± SD in years] | 57.2 ± 14.8 | 61.6 ± 10.3 | 0.338 | ||
BMI [Mean ± SD] | 28.92 ± 6.45 | 30.45 ± 7.23 | 0.485 | ||
ASA score | I | 6 (6.5) | 0 (0.0) | 0.771 | |
II | 66 (71.0) | 9 (69.2) | |||
III | 21 (22.6) | 4 (30.8) | |||
IV | 0 (0.0) | 0 (0.0) | |||
Smoker | Yes | 28 (30.8) | 2 (15.4) | 0.338 | |
No | 63 (69.2) | 11 (84.6) | |||
Comorbidities | |||||
Diabetes | Yes | 13 (14.0) | 6 (46.2) | 0.012 | |
No | 80 (86.0) | 7 (53.8) | |||
Hypertension | Yes | 52 (55.9) | 9 (69.2) | 0.089 | |
No | 41 (44.1) | 4 (30.8) | |||
Cardiovascular diseases | Yes | 7 (7.5) | 6 (46.2) | 0.001 | |
No | 86 (92.5) | 7 (53.8) | |||
Coagulopathy * | Yes | 1 (1.1) | 0 (0.0) | 0.707 | |
No | 92 (98.9) | 13 (100.0) | |||
Chronic inflammation | Yes | 7 (7.5) | 1 (7.7) | 0.983 | |
No | 86 (92.5) | 12 (92.3) | |||
Operative characteristics | |||||
Duration of operation [Mean ± SD in min] | 109.3 ± 75.2 | 88.2 ± 39.7 | 0.405 | ||
Blood loss [Mean ± SD in mL] | 264.52 ± 246.36 | 221.15 ± 242.35 | 0.365 | ||
Duration of hospital stay [Mean in days] | 13.34 | 10.00 | 0.164 | ||
Outcome parameters | |||||
Karnofsky Performance Score [%] | 73.44 | 76.15 | 0.960 | ||
Glasgow Outcome Scale [1–5] | 4.54 | 4.92 | 0.084 |
According to Ibanez’ Classification: | ASA Impact N (%) | No ASA Impact N (%) | p-Value * | |
---|---|---|---|---|
Surgical complication | ||||
None | 12 (92.3) | 72 (77.4) | 0.894 | |
Ia/Ib | 1 (7.7) | 13 (14.0) | ||
IIa/IIb | 0 (0.0) | 4 (4.3) | ||
IIIa/IIIb | 0 (0.0) | 4 (4.3) | ||
IVa/IVb | 0 (0.0) | 0 (0.0) | ||
∑ | 13 (100.0) | 93 (100.0) | ||
Medical complicaions | ||||
None | 13 (100.0) | 85 (91.4) | 0.751 | |
Ia/Ib | 0 (0.0) | 1 (1.1) | ||
IIa/IIb | 0 (0.0) | 3 (3.2) | ||
IIIa/IIIb | 0 (0.0) | 2 (2.2) | ||
IVa/IVb | 0 (0.0) | 2 (2.2) | ||
∑ | 13 (100.0) | 93 (100.0) |
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Tonchev, N.; Pinchuk, A.; Dumitru, C.A.; Stein, K.-P.; Neyazi, B.; Sandalcioglu, I.E.; Rashidi, A. Postoperative Hemorrhage and Venous Thromboembolism in Patients with Pituitary Adenomas Under Acetylsalicylic Acid. J. Clin. Med. 2024, 13, 7020. https://doi.org/10.3390/jcm13237020
Tonchev N, Pinchuk A, Dumitru CA, Stein K-P, Neyazi B, Sandalcioglu IE, Rashidi A. Postoperative Hemorrhage and Venous Thromboembolism in Patients with Pituitary Adenomas Under Acetylsalicylic Acid. Journal of Clinical Medicine. 2024; 13(23):7020. https://doi.org/10.3390/jcm13237020
Chicago/Turabian StyleTonchev, Nikolay, Anatoli Pinchuk, Claudia A. Dumitru, Klaus-Peter Stein, Belal Neyazi, I. Erol Sandalcioglu, and Ali Rashidi. 2024. "Postoperative Hemorrhage and Venous Thromboembolism in Patients with Pituitary Adenomas Under Acetylsalicylic Acid" Journal of Clinical Medicine 13, no. 23: 7020. https://doi.org/10.3390/jcm13237020
APA StyleTonchev, N., Pinchuk, A., Dumitru, C. A., Stein, K. -P., Neyazi, B., Sandalcioglu, I. E., & Rashidi, A. (2024). Postoperative Hemorrhage and Venous Thromboembolism in Patients with Pituitary Adenomas Under Acetylsalicylic Acid. Journal of Clinical Medicine, 13(23), 7020. https://doi.org/10.3390/jcm13237020