Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis

Abstract

<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>The authors of this study aimed to identify the incidence of and risk factors for preoperative deep venous thrombosis (DVT) in patients undergoing surgical treatment for spinal metastases.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>Univariate analysis of patient age, sex, ethnicity, laboratory values, comorbidities, preoperative ambulatory status, histopathological classification, spinal level, and surgical details was performed. Factors significantly associated with DVT univariately were entered into a multivariate logistic regression model.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>The authors identified 314 patients, of whom 232 (73.9%) were screened preoperatively for a DVT. Of those screened, 22 (9.48%) were diagnosed with a DVT. The screened patients were older (median 62 vs 55 years, p = 0.0008), but otherwise similar in baseline characteristics. Nonambulatory status, previous history of DVT, lower partial thromboplastin time, and lower hemoglobin level were statistically significant and independent factors associated with positive results of screening for a DVT. Results of screening were positive in only 6.4% of ambulatory patients in contrast to 24.4% of nonambulatory patients, yielding an odds ratio of 4.73 (95% CI 1.88–11.90). All of the patients who had positive screening results underwent preoperative placement of an inferior vena cava filter.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>Patients requiring surgery for spinal metastases represent a population with unique risks for venous thromboembolism. This study showed a 9.48% incidence of DVT in patients screened preoperatively. The highest rates of preoperative DVT were identified in nonambulatory patients, who were found to have a 4-fold increase in the likelihood of harboring a DVT. Understanding the preoperative thrombotic status may provide an opportunity for early intervention and risk stratification in this critically ill population.</jats:p></jats:sec>

Nomogram for Predicting the Postoperative Venous Thromboembolism in Spinal Metastasis Tumor: A Multicenter Retrospective Study

“…have demonstrated that non-ambulatory status is an independent risk factor for positive finding on preoperative DVT screening. 24% of non-ambulatory patients suffer from DVT, and this incidence of DVT is 4 times higher than that of ambulatory patient population ( 27 ). These conclusions indicate that early gait training is important to prevent VTE, although it may take a long time for the muscle strength to reach the level required for walking.…”

The combination of Caprini risk assessment scale and thrombotic biomarkers to evaluate the risk of venous thromboembolism in critically ill patients

“…ICU clinicians were suggested to pay more attention to these risk factors during the prevention and treatment of VTE. [21–23]…”

A predictive model of preoperative risk factors for venous thromboembolism after fusion for degenerative conditions of the thoracolumbar spine

“…5 Many orthopedic surgery subspecialties have defined standards for VTE prophylaxis, however, there is no consensus on standard prophylaxis in spine surgery. [6][7][8] There is a wide range of prophylaxis mechanism currently used that can be divided into mechanical and pharmacologic categories. Mechanical prophylaxis can include external compression devices, inferior Vena Cava filters, or early mobilization following surgery.…”