TY - JOUR
T1 - Venous thromboembolism events following spinal fractures
T2 - A single center experience
AU - Cloney, Michael B.
AU - Yamaguchi, Jonathan T.
AU - Dhillon, Ekamjeet S.
AU - Hopkins, Benjamin
AU - Smith, Zachary A.
AU - Koski, Tyler R.
AU - Dahdaleh, Nader S.
N1 - Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/11
Y1 - 2018/11
N2 - Objective: :Venous thromboembolic events (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), are a major cause of readmission, morbidity, and mortality after spine surgery. Patients with spinal fractures are particularly at an increased risk for VTE. The objective of this study is to understand VTE risk factors in this patient population and to examine current institutional practices. Patients and Methods: :We retrospectively examined records from 195 consecutive patients with spinal fractures who underwent spinal stabilization surgeries- amongst a cohort of 6869 patients who underwent spinal surgery. We collected data on patient demographics, surgery, hospital course, and 30-day rates of VTE, readmission, reoperation. Multivariable logistic regression was used to identify independent predictors of each outcome. Results: :Among 195 patients undergoing surgery for spinal fractures, 9.2% experienced a VTE, compared to 2.3% among all other spine patients (OR 4.466, p < 0.0001). 48.7% spine fracture patients received chemoprophylactic anticoagulation, compared to 35.7% of all other spine patients (OR 2.657, p < 0.0001). Within 30 days of surgery, estimated blood loss (EBL) was associated with VTE (OR 1.001, p = 0.0415) and DVT (OR 1.001, p = 0.049), and comorbid cardiac disease burden showed a trend toward significance in predicting both VTE (OR 1.890, p = 0.0956) and DVT (OR 4.228, p = 0.0549). Number of levels in surgery predicted PE within 30 days of surgery (OR 1.573, p = 0.0107). Conclusions: : Compared to all other patients undergoing spine surgery, patients with spinal fractures are more likely to receive chemoprophylactic anticoagulation, but nevertheless have a higher rate of VTE events. EBL and comorbid disease burden predict VTE events in patients with spine fractures.
AB - Objective: :Venous thromboembolic events (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), are a major cause of readmission, morbidity, and mortality after spine surgery. Patients with spinal fractures are particularly at an increased risk for VTE. The objective of this study is to understand VTE risk factors in this patient population and to examine current institutional practices. Patients and Methods: :We retrospectively examined records from 195 consecutive patients with spinal fractures who underwent spinal stabilization surgeries- amongst a cohort of 6869 patients who underwent spinal surgery. We collected data on patient demographics, surgery, hospital course, and 30-day rates of VTE, readmission, reoperation. Multivariable logistic regression was used to identify independent predictors of each outcome. Results: :Among 195 patients undergoing surgery for spinal fractures, 9.2% experienced a VTE, compared to 2.3% among all other spine patients (OR 4.466, p < 0.0001). 48.7% spine fracture patients received chemoprophylactic anticoagulation, compared to 35.7% of all other spine patients (OR 2.657, p < 0.0001). Within 30 days of surgery, estimated blood loss (EBL) was associated with VTE (OR 1.001, p = 0.0415) and DVT (OR 1.001, p = 0.049), and comorbid cardiac disease burden showed a trend toward significance in predicting both VTE (OR 1.890, p = 0.0956) and DVT (OR 4.228, p = 0.0549). Number of levels in surgery predicted PE within 30 days of surgery (OR 1.573, p = 0.0107). Conclusions: : Compared to all other patients undergoing spine surgery, patients with spinal fractures are more likely to receive chemoprophylactic anticoagulation, but nevertheless have a higher rate of VTE events. EBL and comorbid disease burden predict VTE events in patients with spine fractures.
KW - Chemoprophylaxis
KW - Deep vein thrombosis
KW - Pulmonary embolism
KW - Spine surgery
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U2 - 10.1016/j.clineuro.2018.08.030
DO - 10.1016/j.clineuro.2018.08.030
M3 - Article
C2 - 30189328
AN - SCOPUS:85052652544
SN - 0303-8467
VL - 174
SP - 7
EP - 12
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
ER -