Abstract
The aim of this study was to investigate the presence of preoperative DVT following spinal fracture and the association between the presence of DVT and risk factors. Ultrasonography and blood analyses were performed preoperatively in patients diagnosed with spinal fracture between October 2014 and December 2018. Univariate analyses were performed on the data of demographics, comorbidities, location of injury, spinal cord injury (SCI) grading and laboratory biomarkers. The receiver operating characteristic (ROC) curve analysis was employed to obtain the optimal D-dimer cut-off value for diagnosis. In total, 2432 patients with spinal fractures were included, among whom 108 (4.4%) patients had preoperative DVTs. The average interval between fracture and initial diagnosis of DVT was 4.7 days (median, 2 days), ranging from 0 to 20 days; 78 (72.2%) were diagnosed within 7 days after injury and 67 (62.0%) within 3 days; 19 (17.5%) patients had proximal vein involved and 89 (82.4%) presented in distal veins. Multivariate logistic regression suggested six risk factors independently correlated to DVT, including delay to DUS (in each day) (odds ratio [OR] = 1.11), ASA class III–IV (OR = 2.36), ASIA grade (A/B) (OR = 2.36), ALB < 3.5 g/dL (OR = 2.08), HDL-C < 1.1 mmol/L (OR = 1.68) and d-Dimer > 1.08 µg/ml (OR = 2.49).
Highlights
The aim of this study was to investigate the presence of preoperative deep venous thrombosis (DVT) following spinal fracture and the association between the presence of DVT and risk factors
DVT is extensively studied in patients following major orthopedic surgery, the explicit guideline of perioperative prophylactic anticoagulation with regard to spinal fracture remains absent
It is necessary to identify the preoperative DVT and perform timely evaluation by finding some certain predictive indicators. This retrospective study was designed to investigate the epidemiologic characteristics of preoperative DVT following spinal fracture based on the current diagnostic methodology and treatment algorithms in our institution, which might be conducive to early assessment on risk stratification for DVT
Summary
The aim of this study was to investigate the presence of preoperative DVT following spinal fracture and the association between the presence of DVT and risk factors. DVT is extensively studied in patients following major orthopedic surgery (total hip and knee arthroplasty, hip fracture surgery), the explicit guideline of perioperative prophylactic anticoagulation with regard to spinal fracture remains absent. A paucity of epidemiologic data on preoperative DVT following spinal fracture still exists, such as the incidence rate, locations and associated. It is necessary to identify the preoperative DVT and perform timely evaluation by finding some certain predictive indicators This retrospective study was designed to investigate the epidemiologic characteristics of preoperative DVT following spinal fracture based on the current diagnostic methodology and treatment algorithms in our institution, which might be conducive to early assessment on risk stratification for DVT. The secondary goal was to determine the risk factors for predicting the presence of DVT from the preexisting comorbidities or initial biomarkers at admission
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