Prevalence of Venous Thromboembolic Events After Elective Major Thoracolumbar Degenerative Spine Surgery

Hohl, Justin B.; Lee, Joon Y.; Rayappa, Steven; Nabb, Colin E.; Devin, Clinton J.; Kang, James D.; Ward, W. Timothy; Donaldson, William F.

doi:10.1097/bsd.0b013e31828b7d82

Cited by 38 publications

(39 citation statements)

References 24 publications

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“…They reported asymptomatic PE and DVT in 18% and 19% of patients, respectively. Hohl et al 2 conducted a multi-institutional study of patients who underwent spine surgery and reported that the prevalence of VTE was 1.5%, symptomatic PE 0.88%, and DVT 0.66%. They also reported that patients >65 years at the time of surgery had a 2.196 times higher prevalence of DVT and PE.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Venous Thromboembolism After Spine Surgery

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Venous Thromboembolism After Spine Surgery

et al. 2015

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“…To simplify this in our algorithm, the time of procedure was analogous to the number of levels performed and the use of a combined approach. Previously, Hohl et al 30 found a 2.3% rate of symptomatic pulmonary embolism when ! 4 levels were fused versus 1.4% in 3-level fusions, 0.78% in 2-level fusions, and 0.77% in 1-level fusions.…”

Section: Discussionmentioning

confidence: 94%

An Evidence-Based Algorithm for Determining Venous Thromboembolism Prophylaxis After Degenerative Spinal Surgery

et al. 2020

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Background: Although venous thromboembolism (VTE) is a potentially serious and life-threatening complication, there is no widely accepted protocol to guide VTE prophylaxis in adult degenerative spinal surgery, and pharmacologic overtreatment may result in hemorrhagic complications. Previously, we published the VTE Prophylaxis Risk/Benefit Score, an evidence-based algorithm that balances the risk and consequences of thrombotic versus hemorrhagic complications by taking consideration of patient-related risks, procedure-related risks, and the risk of neurological compromise to guide VTE prophylaxis. To objective of this study was to validate the VTE Prophylaxis Risk/Benefit Score. Methods: From January 1, 2016, to December 31, 2017, VTE Prophylaxis Risk/Benefit Scores and corresponding prophylaxes were prospectively assigned. When indicated, chemoprophylaxis was dosed 24 to 36 hours postoperatively to allow for adequate surgical hemostasis. Patients were retrospectively evaluated for immediate and short-term complications. The Fisher exact test compared incidence of complications by VTE prophylaxis. Multinomial logistic regression modeled the probability of complication by prophylaxis type, demographics, and comorbidities. Significance was set at P , .05. Results: Of the 266 patients who met inclusion criteria, 79.3% were given mechanical prophylaxis alone and 20.7% were given combined mechanical and chemical prophylaxis. Complications including VTE (0.38%), delayed wound healing or infection (2.26%), and hematoma (0.75%) were observed at rates similar to or lower than previously published studies with increased utilization of chemoprophylaxis. Use of chemoprophylaxis and continuation of perioperative aspirin were significantly associated with the development of a hemorrhagic complication. No patient developed persistent neurologic deficit from hematoma or pulmonary embolism. Conclusions: The VTE Prophylaxis Risk/Benefit Score comprehensively considers the risk of thrombotic, wound, and bleeding complications and is an effective tool for determining appropriate thromboprophylaxis in adult degenerative spinal surgery. Level of Evidence: 3.

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“… 17 A multi-institutional study by Hohl et al about patients who underwent spinal surgery, also reported 1.5%, 0.88%, and 0.66% as the prevalence rate for VTE, symptomatic PE and DVT respectively. 33 Epidural hematoma is a serious complication after spinal surgery that results in spinal paresis. The result of this study showed epidural hematoma incidence of 0.1% which is consistent with that of the symptomatic postoperative epidural hematoma incidence ranging from 0.1% to 3.0% being reported.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported that major surgery had a high risk of VTE. 32 , 33 , 37 Multilevel spinal instrumented fusion surgery also induces long operative time, prolonged bed rest, much bleeding, as well as much blood transfusion. These factors result in a high risk of VTE associated with decompression surgery and posterior lumbar interbody fusion.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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This cross-sectional study was designed to obtain the current prevalence of deep vein thrombosis (DVT) and analyze related risk factors in patients undergoing lumbar interbody fusion.Medical record data were collected from Department of Spinal Surgery, The Third Hospital of Hebei Medical University, between July 2014 and March 2015. Both univariate analysis and binary logistic regression analysis were performed to determine risk factors for DVT.A total of 995 patients were admitted into this study, including 484 men and 511 women, aged from 14 to 89 years old (median 50, IQR 19). The detection rate of lower limb DVT by ultrasonography was 22.4% (223/995) in patients undergoing lumbar interbody fusion. Notably, average VAS (visual analog scale) score in the first 3 days after surgery in the DVT group was more than that in the non-DVT group (Z = −21.69, P < 0.001). The logistic regression model was established as logit P = −13.257 + 0.056∗X1 − 0.243∗X8 + 2.085∗X10 + 0.001∗X12, (X1 = age; X8 = HDL; X10 = VAS; X12 = blood transfusion; x2 = 677.763, P < 0.001).In conclusion, advanced age, high postoperative VAS scores, and blood transfusion were risk factors for postoperative lower limb DVT. As well, the logistic regression model may contribute to an early evaluation postoperatively to ascertain the risk of lower limb DVT in patients undergoing lumbar interbody fusion surgery.

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Prevalence of Venous Thromboembolic Events After Elective Major Thoracolumbar Degenerative Spine Surgery

Cited by 38 publications

References 24 publications

Risk Factors for Venous Thromboembolism After Spine Surgery

Risk Factors for Venous Thromboembolism After Spine Surgery

An Evidence-Based Algorithm for Determining Venous Thromboembolism Prophylaxis After Degenerative Spinal Surgery

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

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