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.
Highlights
Most of the literature and international guidelines on Venous thromboembolism (VTE) emphasize that prevention is more important and cost-effective than treatment, because once VTE develops, it can only be cured at considerable expense
Linear-by-linear association test (χ2 = 8.073, p = 0.004) showed significant difference regarding deep vein thrombosis (DVT) incidence in single level (13.7%), double levels (21.3%), and three levels or above (25.8%)
DVT incidence was 13.5% in patients treated by low-molecular-weight heparin (LMWH), whereas it was only 8.1% in patients without LMWH prophylaxis
Summary
Most of the literature and international guidelines on VTE emphasize that prevention is more important and cost-effective than treatment, because once VTE develops, it can only be cured at considerable expense. Common prophylactic treatment mainly includes two types of therapies. Only a few studies have reported the effect of LMWH prophylaxis with controversial conclusions[4,12,13]. DVT is common seen in patients undergoing spine surgery, its prevalence and associated risk factors have not been well understood yet. This retrospective case-cohort study is designed to investigate the prevalence of DVT and explore the risk factors associated with DVT in the patients after spine surgery. The secondary goal is to assess the effect of LMWH prophylaxis in patients undergoing degenerative spine surgery
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