Comparative efficacy of certoparin, enoxaparin, and combined thromboprophylaxis on thromboembolic events after glioblastoma resection: a prospective observational study

Abstract

Abstract Thromboembolic events (TE) are serious complications following glioblastoma (GBM) resection. This retrospective study analyzed 695 GBM patients (2017–2022, University Hospital Dresden) to assess the impact of different anticoagulant regimens—certoparin, enoxaparin, and enoxaparin with intermittent pneumatic stockings (IPS)—along with patient comorbidities, on TE incidence. Overall, 28 patients (4%) developed TE. The highest combined incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) occurred in the enoxaparin group (8.6%), followed by certoparin (6.9%) and enoxaparin + IPS (2.6%) ( p  = .003). Increased PE risk was associated with longer surgery duration (median 249 vs. 190 min; p  = .002), greater intraoperative blood loss (300 vs. 150 mL; p  = .002), and older age (> 65 years, p  = .043). Comorbidities such as diabetes ( p  = .005) and coronary heart disease ( p  = .037) were also linked to elevated TE risk. Multivariate analysis identified enoxaparin alone as an independent risk factor (HR 0.312; CI 0.116–0.842; p  = .022). Patients with PE or DVT had surgeries that were on average 45 min longer and involved higher blood loss. GBM patients treated with enoxaparin alone have a significantly higher risk for TE compared to treatment with certoparin or the combination of enoxaparin with IPS. Additionally, the duration of surgery, patient age and comorbidities significantly influence the risk of postoperative TE.