Venous thromboembolism events following spinal fractures: A single center experience

Cloney, Michael; Yamaguchi, Jonathan T.; Dhillon, Ekamjeet S.; Hopkins, Ben; Smith, Zachary A.; Koski, Tyler R.; Dahdaleh, Nader S.

doi:10.1016/j.clineuro.2018.08.030

Cited by 18 publications

(21 citation statements)

References 25 publications

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“…Cloney et al 5 evaluated VTE-related events in 195 patients undergoing surgery for spinal fractures. They found that compared with other patients undergoing spine surgery, patients with spinal fractures were more likely to receive chemoprophylactic anticoagulation and also experienced higher rates of VTE events.…”

Section: Timing Of Chemoprophylaxismentioning

confidence: 99%

“…The authors also found that within 30 days of surgery, estimated blood loss and comorbid cardiac disease predicted VTE events in patients with spinal fractures. 5 Given the paucity of high-quality literature regarding the efficacy and safety of chemoprophylaxis selection and timing, current practice varies widely, and is largely based on surgeons' preference. Proper knowledge regarding available agents and optimal timeframe for initiation of thromboprophylaxis postoperatively following spine surgery is imperative to maximize benefits of thromboembolic events and minimize risks associated with postoperative bleeding complications.…”

Section: Introductionmentioning

confidence: 99%

“…Based on the pooled results, the authors recommended the use of thromboprophylaxis to reduce the risk of VTE events in this specific population. 4 Cloney et al 5 evaluated VTE-related events in patients undergoing surgery for spinal fractures. Analysis of 195 patients revealed that compared with other patients undergoing spine surgery, patients with spinal fractures were more likely to receive chemoprophylactic anticoagulation, but experienced higher rates of VTE events.…”

Section: Introductionmentioning

confidence: 99%

“…The authors also found that within 30 days of surgery, estimated blood loss and comorbid cardiac disease predicted VTE events in patients with spinal fractures. 5…”

Section: Introductionmentioning

confidence: 99%

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Venous Thromboprophylaxis in Spine Surgery

Alvarado

Porto

Wessell

et al. 2019

Global Spine Journal

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Study Design: Review article. Objective: A review of the literature on postoperative initiation of thrombophylactic agents following spine surgery. Methods: A review of the literature and synthesis of the data to provide an update on venous thromboprophylaxis following spine surgery. Results: Postoperative regimens of venous thromboprophylaxis measures following spine surgery remain a controversial issue. Recommendations regarding mechanical versus chemical prophylaxis vary greatly among institutions. Conclusion: Postoperative spine surgery initiation of thromboprophylaxis remains controversial regarding optimal timing and agent selection. The benefits of deep vein thrombosis/pulmonary embolism prophylaxis must be weighed against the possible postoperative complications associated with spine surgery.

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Section: Timing Of Chemoprophylaxismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The authors also found that within 30 days of surgery, estimated blood loss and comorbid cardiac disease predicted VTE events in patients with spinal fractures. 5…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Venous Thromboprophylaxis in Spine Surgery

Alvarado

Porto

Wessell

et al. 2019

Global Spine Journal

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“…It is estimated that around 50% of untreated DVT events can be complicated by PE; likewise, if untreated, 50% to 80% of PE cases are related to DVT events [5, 11]. Previous studies have uncovered that VTE events are possibly associated with the following risk factors: D-dimer, trauma, smoking, obesity, advanced age, neurological deficit, immobilization, malignancy, blood transfusion, major surgery, hospitalization, and inherited hypercoagulable state [12–16].…”

Section: Introductionmentioning

confidence: 99%

Time-to-event analyses of lower-limb venous thromboembolism in aged patients undergoing lumbar spine surgery: a retrospective study of 1620 patients

Liang

Huo

et al. 2019

Aging

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After spine surgery, venous thromboembolism (VTE) is not uncommon in aged patients. This study investigates time-to-event risk factors of postoperative VTE based on medical records of aged patients (age≥60 yr) between January 2013 and December 2018. All participants had undergone lower extremity ultrasonography pre- and postoperatively at the first, second, fourth, eighth, and twelfth weeks. Mann-Whitney U tests and chi-square tests were used for univariate analyses, and Cox regression was utilized for multivariate analyses. A total of 1620 cases were recruited, VTE group (N=382, 23.6%) and non-VTE group (N=1238, 76.4%), aged 67 (IQR 11) years and 65 (IQR 6) years, respectively. The univariate analyses indicated significant differences between the VTE and non-VTE groups regarding advanced age, VTE history, hypertension, fusion, hospital stay, FIB, HDL, D-dimer, and TC (all P<0.05). The Cox regression showed that advanced age (OR=1.108; 95% CI, 1.091–1.126), VTE history (OR=4.962; 95% CI, 3.849–6.397), and hypertension (OR=1.344; 95% CI, 1.084–1.667) were the risk factors for postoperative VTE (P<0.05). The time-to-event analyses indicated that the hazard of VTE formation was highest in the first postoperative week. In conclusion, advanced age, VTE history, and hypertension are main risks for VTE formation, particularly in the first postoperative week.

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Nomogram for predicting venous thromboembolism after spinal surgery

Kong,

Shao,

et al. 2023

Eur Spine J

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Purpose This study aimed to establish a nomogram to predict the risk of venous thromboembolism (VTE), identifying potential risk factors, and providing theoretical basis for prevention of VTE after spinal surgery. Methods A retrospective analysis was conducted on 2754 patients who underwent spinal surgery. The general characteristics of the training group were initially screened using univariate logistic analysis, and the LASSO method was used for optimal prediction. Subsequently, multivariate logistic regression analysis was performed to identify independent risk factors for postoperative VTE in the training group, and a nomogram for predict risk of VTE was established. The discrimination, calibration, and clinical usefulness of the nomogram were separately evaluated using the C-index, receiver operating characteristic curve, calibration plot and clinical decision curve, and was validated using data from the validation group finally. Results Multivariate logistic regression analysis identified 10 independent risk factors for VTE after spinal surgery. A nomogram was established based on these independent risk factors. The C-index for the training and validation groups indicating high accuracy and stability of the model. The area under the receiver operating characteristic curve indicating excellent discrimination ability; the calibration curves showed outstanding calibration for both the training and validation groups. Decision curve analysis showed the clinical net benefit of using the nomogram could be maximized in the probability threshold range of 0.01–1. Conclusion Patients undergoing spinal surgery with elevated D-dimer levels, prolonger surgical, and cervical surgery have higher risk of VTE. The nomogram can provide a theoretical basis for clinicians to prevent VTE.

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Venous thromboembolism events following spinal fractures: A single center experience

Cited by 18 publications

References 25 publications

Venous Thromboprophylaxis in Spine Surgery

Venous Thromboprophylaxis in Spine Surgery

Time-to-event analyses of lower-limb venous thromboembolism in aged patients undergoing lumbar spine surgery: a retrospective study of 1620 patients

Nomogram for predicting venous thromboembolism after spinal surgery

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