Introduction Cushing's disease (CD) is associated with hypercoagulability which is associated with an increased risk of venous thromboembolic events (VTEs) perioperatively. This risk persists even after successful transsphenoidal surgery (TSS). However, there are no current guidelines for pharmacologic thromboprophylaxis in this patient population.

Objective Characterize existing thromboprophylaxis management practices in patients undergoing TSS for CD.

Methods An anonymous RedCap survey comprised of questions about perioperative thromboprophylaxis in CD patients was distributed via the American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) Joint Tumor Section and the North American Skull Base Society (NASBS) email lists.

Results The survey was distributed to 554 members of the AANS/CNS Joint Tumor Section and 1,094 members of NASBS asking that members who surgically treat CD respond. Sixty responses (3.0% response rate) were received. Fifty-two (86.7%) respondents are involved in the postoperative management of CD patients. Thirty-six (69.2%) treat all patients with postoperative VTE chemoprophylaxis, 8 (15.4%) treat some patients, while 8 (15.4%) do not use chemoprophylaxis. Preferred chemoprophylaxis varies as 26 (59.1%) administer low molecular weight heparin, 14 (31.8%) give unfractionated heparin, 1 (2.3%) give direct oral anticoagulants, and 3 (6.8%) give aspirin. Most (28, 53.8%) of the respondents perceive the VTE risk in this patient population to be 0 to 5%, 16 (30.8%) perceive the risk to be 6 to 10%, and 8 (15.4%) perceive it to be 11 to 20%.

Conclusion There is great variability in VTE detection and postoperative prevention practice patterns in CD patients. This study highlights the need for prospective studies to clarify optimal pharmacologic chemoprophylaxis strategies and duration in this patient population.

简介 库欣病 (CD) 与高凝状态相关，而高凝状态又与围手术期静脉血栓栓塞事件 (VTE) 风险增加相关。即使经蝶手术 (TSS) 成功后，这种风险仍然存在。然而，目前尚无针对此类患者群体的药物血栓预防指南。

目的 描述接受 TSS 治疗 CD 的患者现有的血栓预防管理实践。

方法 通过美国神经外科医生协会 (AANS)/神经外科医生大会 (CNS) 联合肿瘤分会和北美颅基协会 (NASBS) 电子邮件列表分发了一项匿名 RedCap 调查，其中包括有关 CD 患者围手术期血栓预防的问题。

结果 该调查已分发给 AANS/CNS 联合肿瘤科的 554 名成员和 NASBS 的 1,094 名成员，要求接受手术治疗 CD 的成员做出回应。收到 60 份答复（答复率为 3.0%）。52 名（86.7%）受访者参与了 CD 患者的术后管理。36 例（69.2%）对所有患者进行术后 VTE 化学预防，8 例（15.4%）对部分患者进行治疗，8 例（15.4%）不使用化学预防。优选的化学预防方法各不相同，26 名患者 (59.1%) 给予低分子量肝素，14 名患者 (31.8%) 给予普通肝素，1 名患者 (2.3%) 给予直接口服抗凝剂，3 名患者 (6.8%) 给予阿司匹林。大多数（28 人，53.8%）受访者认为该患者群体的 VTE 风险为 0 至 5%，16 人（30.8%）认为风险为 6 至 10%，8 人（15.4%）认为风险为11%至20%。

结论 CD 患者的 VTE 检测和术后预防实践模式存在很大差异。这项研究强调需要进行前瞻性研究来阐明该患者群体的最佳药物化学预防策略和持续时间。