The evidence was initially of high quality but was down- graded due to limitations in study design (mostly selection bias), indirectness (outcomes were rarely reported) and impreciseness (different magnitudes of predictive power of risk factors between studies). However, the strength of the recommendation was view as strong by the working group, considering the seriousness of the complication and health/economic impact of missing a patient with a neurosurgical lesion. The working group also discussed older age (≥60 years and ≥65 years) as well as antiplatelet