NMES verlaagt DVT-risico in vergelijking met pneumatische compressie bij neurochirurgiepatiënten

BACKGROUND: Deep vein thrombosis (DVT) considerably affects the incidence and mortality rates in patients undergoing neurosurgery. Neuromuscular electrical stimulation (NMES) and intermittent pneumatic compression (IPC) are frequently used as adjunct treatments to prevent DVT; however, their effects remain unclear. This study was conducted to compare the association of NMES and IPC as two mechanical prophylaxis strategies in neurosurgical patients who were ineligible for pharmacological prophylaxis. METHODS: Postoperative neurosurgical patients were retrospectively enrolled from a single centre between January 2020 and December 2021. These patients were assessed to have a high bleeding risk and received either NMES or IPC as mechanical prophylaxis. Univariable analysis was used to explore the risk factors for DVT, and multivariable logistic regression analysis was used to determine the independent associations between DVT and potential variables after adjusting for confounding factors. RESULTS: Among 232 patients who underwent neurosurgery, 131 received IPC and 101 received NMES, with no overlap between the two groups. DVT was diagnosed in 62 patients (11 received NMES and 51 received IPC). After controlling for sex, age, operation duration and length of hospital stay, NMES use was associated with a lower incidence of DVT (OR = 0.268, 95% CI = 0.125-0.576, p = .001). Moreover, men were less likely to have DVT than women (OR = 0.469, 95% CI = 0.242-0.910, p = .025), older age was associated with higher odds of DVT (OR = 3.419, 95% CI = 1.594-7.334, p = .002), and a longer operation duration was associated with higher odds of DVT (OR = 2.180, 95% CI = 1.042-4.560, p = .039). CONCLUSION: This study found an association between NMES and reduced odds of DVT compared with IPC in neurosurgery patients. Although NMES may be more widely adopted in neurosurgery to decrease the incidence of DVT, further evidence is required to determine its effectiveness in clinical practice.