Prevalence and risk factors of deep vein thrombosis in patients after spine surgery: a retrospective case-cohort study

Abstract

Deep vein thrombosis (DVT) is common seen in patients undergoing spine surgery. However, its prevalence and associated risk factors have not been well understood yet. This retrospective case-cohort study was designed to investigate risk factors for postoperative DVT using retrospectively collected data from department of spine surgery between 07/2013 and 07/2014. Univariate analysis and binary logistic regression analysis were used to determine risk factors for DVT. A total of 861 patients were admitted into DVT-associated analyses, including 410 males and 451 females, aged from 15 to 87 years old (median 54, IQR 18). Of them, 147 cases (17%) sustained postoperative DVT. DVT incidence was 15.9% in patients undergoing lumbar interbody fusion, 13.5% in patients treated by low-molecular-weight heparin (LMWH), while only 8.1% in patients without LMWH. However, it revealed no significant difference between LMWH group and non-LMWH group (χ2 = 1.933, p = 0.164). Logistic regression equation was logit P = −4.09 + 0.05*X1 − 0.55*X2 + 0.41*X3 + 1.41*X7, (X1 = age; X2 = regions; X3 = hypertension; X7 = D-dimer). In this study, LMWH prophylaxis after spine surgery proved ineffective. Advanced age, D-dimer and hypertension have proved to be the risk factors for postoperative DVT in patients undergoing spine surgery.

Factors predicting venous thromboembolism after spine surgery

“…Yang et al [30] proved that a history of HT significantly increased the incidence for VTE, but Tominaga et al [31] had an idea that was opposite of that of Yang et al In our analysis, the result showed that a history of HT significantly increased the incidence for VTE ( P  = 0.001). We had a hypothesis that the vascular elasticity was usually not well for the patients with HT, which may affect hemodynamics and blood coagulation mechanism, and this may be related to higher incidence of VTE postoperation.…”

“…Six studies [30–35] reported relation between history of diabetes and incidence of VTE. The result showed that a history of diabetes significantly increased the incidence of VTE ( P  = 0.03, OR = 2.12, 95% CI [1.09, 4.10]; heterogeneity: P  < 0.0001, I 2  = 81%, random-effects model; Fig.…”

“…Six studies [30–33,35,36] reported relation between anticoagulation therapy and incidence of VTE. The result showed that anticoagulation therapy did not affect incidence of VTE ( P  = 0.31, OR = 0.64, 95% CI [0.27, 1.51]; heterogeneity: P  = 0.002, I 2  = 74%, random-effects model; Fig.…”

“…Five studies [30–33,35] reported the relation between history of HT and incidence of VTE. Yang et al [30] proved that a history of HT significantly increased the incidence for VTE, but Tominaga et al [31] had an idea that was opposite of that of Yang et al In our analysis, the result showed that a history of HT significantly increased the incidence for VTE ( P  = 0.001).…”

Deep Vein Thrombosis Prophylaxis Evaluation in Intensive Care Unit

“…One of the most common and serious complications in ICU patients was venous thromboembolism and PE causes about 10% of hospital deaths (7). In comparison with VTE treatment, prophylaxis has more significant effect and is more cost-effective (8). Thus an adequate prophylaxis (medicinal or physical) is necessary for ICU patients.…”