Prevalence and Risk Factors of Deep Vein Thrombosis in Patients Undergoing Lumbar Interbody Fusion Surgery

Yang, Sidong; Ding, Wenyuan; Yang, Dalong; Shen, Yong; Zhang, Yingze; Feng, Shiqing; Zhao, Fengdong

doi:10.1097/md.0000000000002205

Cited by 32 publications

(28 citation statements)

References 38 publications

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“…Johnson et al 28 demonstrated increased odds of composite thrombotic events equal to 1.104 per RBC unit (95% CI 1.032-1.194, P = .0035). Similarly, Yang et al 41 reported that large blood transfusions were associated with increased rates of postoperative DVT in lumbar fusion patients ( P = .04). The only inconclusive report among these studies was limited by a small rate of events (3 in 160 patients).…”

Section: Resultsmentioning

confidence: 84%

Clinical Outcomes Associated With Allogeneic Red Blood Cell Transfusions in Spinal Surgery: A Systematic Review

Blackburn

Morrow

Tanenbaum

et al. 2018

Global Spine Journal

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Study Design: Systematic review. Objectives: The objectives of this systematic review were to report the available clinical evidence on patient outcomes associated with perioperative allogeneic red blood cell (RBC) transfusions in adult patients undergoing spinal surgery and to determine whether there is any evidence to support an association between transfusion timing and clinical outcomes. Methods: A systematic review of the PubMed, EMBASE, and Cochrane Library databases was performed to identify all articles examining outcomes of adult spinal surgery patients who received perioperative allogeneic RBC transfusions. The level of evidence for each study was assessed using the “Oxford Levels of Evidence 2” classification system. Meta-analysis was not performed due to the heterogeneity of reports. Results: A total of 2759 unique citations were identified and 76 studies underwent full-text review. Thirty-four studies were selected for analysis. All the studies, except one, were retrospective. Eleven studies investigated intraoperative or postoperative transfusions. Only one article compared outcomes related to intraoperative versus postoperative transfusions. Conclusions: Perioperative transfusion is associated with increased rates of postoperative complications, especially infectious complications, and prolonged length of stay. Some evidence suggests that a dose-response relationship may exist between morbid events and the number of RBC units administered, but these findings are inconsistent. Because of the heterogeneity of reports and inconsistent findings, the incidence of specific complications remains unclear. Limited research activity has focused on intraoperative versus postoperative transfusions, or the effect of transfusion on functional outcomes of spine surgery patients. Further research is warranted to address these clinical issues.

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Section: Resultsmentioning

confidence: 84%

Clinical Outcomes Associated With Allogeneic Red Blood Cell Transfusions in Spinal Surgery: A Systematic Review

Blackburn

Morrow

Tanenbaum

et al. 2018

Global Spine Journal

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“…Yang et al 5 revealed that the DVT incidence was 17% (147/861 patients) after spinal surgery, including fusion and nonfusion surgery. However, they reported in another study 10 that the rate of lower limb DVT detection by ultrasonography was 22.4% (223/995) in patients who underwent lumbar interbody fusion; the same authors reported 2 different results regarding the incidence of lower limb DVT. Perhaps they performed different surgical procedures for various spinal diseases, such as cervical spondylopathy, thoracic diseases, and lumbar disc degenerative diseases, which were evaluated together.…”

Section: Discussionmentioning

confidence: 96%

Risk Factors for Lower Limb Deep Vein Thrombosis in Patients With Single-Level Lumbar Fusion: A Prospective Study of 710 Cases

Zhao

Yang

Huang

et al. 2018

Clin Appl Thromb Hemost

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Lower limb deep vein thrombosis (DVT) is not an uncommon postoperative complication of spinal fusion surgery. However, the related risk factors identified in previous studies remain controversial. This study aimed to investigate risk factors for lower limb DVT in patients with single-level lumbar fusion surgery. Between January 2010 and December 2016, a total of 710 patients undergoing lumbar fusion were recruited for this study, including 172 males and 538 females (aged 18-75 years). Deep vein thrombosis was detected by ultrasonography. Accordingly, patients were divided into the DVT group and the non-DVT group and compared in terms of operative data, underlying diseases, and biochemical data. Additionally, logistic regression analysis was performed to identify risk factors for lower limb DVT. The incidence of lower limb DVT was 11.8% (84 of 710 cases). Five patients were symptomatic, with lower limb pain and swelling. Two patients developed pulmonary embolism and 1 died. Binary logistic regression indicated that advanced age ( P = .001, odds ratio [OR] = 2.86, 95% CI: 1.85-5.12), hypertension ( P = .006, OR = 4.10, 95% CI: 1.09-2.30), and increased d-dimer ( P < .001, OR = 3.49, 95% CI: 2.05-6.36) were risk factors for postoperative DVT. In conclusion, for patients with single-level lumbar fusion, advanced age, increased d-dimer, and hypertension may contribute to DVT development after spinal fusion surgery. Therefore, patients with these risk factors should be protected during the perioperative period.

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“…The major acquired factors include malignancy, recent major surgery, prior thrombotic event, pregnancy, oral contraceptives, hormone replacement therapy, immobilization, antiphospholipid antibody syndrome, and myeloproliferative disorders [32]. Blood transfusion might have an effect on thromboembolic disease, for example; red blood cell (RBC) and platelet transfusions are associated with an increased risk of venous and arterial thrombotic events and mortality only in hospitalized cancer patients and postoperative procedures [33, 34]. Each unit of fresh frozen plasma (FFP) increased VTE risk by 25% in patients who required less than 4 units of RBC.…”

Section: Discussionmentioning

confidence: 99%

Should Prophylactic Anticoagulation Be Considered with Large Uterine Leiomyoma? A Case Series and Literature Review

Satti

Saenz

Raju

et al. 2016

Case Reports in Obstetrics and Gynecology

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Introduction. Uterine leiomyomas, also called uterine fibroids or myomas, are the most common pelvic tumors in women. They are very rarely the cause of acute complications. However, when complications occur they cause significant morbidity and mortality. Thromboembolic disease has been described as a rare complication of uterine leiomyomas. DVT is a serious illness, sometimes causing death due to acute PE. Cases. We report a case series of 3 patients with thromboembolic disease associated with uterine leiomyoma at Hurley Medical Center, Flint, Michigan, during 2015 and conduct a literature review on the topic. A literature search was conducted using Medline, PubMed, and PMC databases from 1966 to 2015. Conclusion. The uterine leiomyoma is a very rare cause of PE and only few cases have been reported. DVT secondary to uterine leiomyoma should be considered in a female presenting with abdominal mass and pelvic pressure, if there is no clear common cause for her symptoms. Thromboembolic disease secondary to large uterine leiomyoma should be treated with acute stabilization and then hysterectomy. Prophylactic anticoagulation would be beneficial for lowering the risk of VTE in patients with large uterine leiomyoma.

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Prevalence and Risk Factors of Deep Vein Thrombosis in Patients Undergoing Lumbar Interbody Fusion Surgery

Cited by 32 publications

References 38 publications

Clinical Outcomes Associated With Allogeneic Red Blood Cell Transfusions in Spinal Surgery: A Systematic Review

Clinical Outcomes Associated With Allogeneic Red Blood Cell Transfusions in Spinal Surgery: A Systematic Review

Risk Factors for Lower Limb Deep Vein Thrombosis in Patients With Single-Level Lumbar Fusion: A Prospective Study of 710 Cases

Should Prophylactic Anticoagulation Be Considered with Large Uterine Leiomyoma? A Case Series and Literature Review

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