Venous thromboembolism and pulmonary embolism in spine surgery: Incidence, prevention, and management

Zelenty, William D.; Sama, Andrew A.

doi:10.1016/j.semss.2022.100923

Cited by 3 publications

(2 citation statements)

References 44 publications

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“…For example, early mobilization along with the use of postoperative anticoagulation and sequential compression devices (SCDs) reduce the risk of DVT and PE, and these postoperative protocols could be more frequently used in Black patients at higher risk for these adverse outcomes. 23 Interestingly, Black patients had markedly lower readmission rates than White patients for the causes of superficial and organ/space SSI. Although it is possible that these patients could be experiencing these complications at a lower rate, it is equally possible that healthcare providers may be minimizing valid concerns of marginalized groups, as has been previously reported on in the literature.…”

Section: Discussionmentioning

confidence: 98%

Racial Disparities in 30-day Readmission After Orthopaedic Surgery: A 5-year National Surgical Quality Improvement Program Database Analysis

Bergstein,

O'Sullivan,

Levy

et al. 2024

JAAOS Glob Res Rev

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Background: Readmission rate after surgery is an important outcome measure in revealing disparities. This study aimed to examine how 30-day readmission rates and causes of readmission differ by race and specific injury areas within orthopaedic surgery. Methods: The American College of Surgeon-National Surgical Quality Improvement Program database was queried for orthopaedic procedures from 2015 to 2019. Patients were stratified by self-reported race. Procedures were stratified using current procedural terminology codes corresponding to given injury areas. Multiple logistic regression was done to evaluate associations between race and all-cause readmission risk, and risk of readmission due to specific causes. Results: Of 780,043 orthopaedic patients, the overall 30-day readmission rate was 4.18%. Black and Asian patients were at greater (OR = 1.18, P < 0.01) and lesser (OR = 0.76, P < 0.01) risk for readmission than White patients, respectively. Black patients were more likely to be readmitted for deep surgical site infection (OR = 1.25, P = 0.03), PE (OR = 1.64, P < 0.01), or wound disruption (OR = 1.45, P < 0.01). For all races, all-cause readmission was highest after spine procedures and lowest after hand/wrist procedures. Conclusions: Black patients were at greater risk for overall, spine, shoulder/elbow, hand/wrist, and hip/knee all-cause readmission. Asian patients were at lower risk for overall, spine, hand/wrist, and hip/knee surgery all-cause readmission. Our findings can identify complications that should be more carefully monitored in certain patient populations.

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Section: Discussionmentioning

confidence: 98%

Racial Disparities in 30-day Readmission After Orthopaedic Surgery: A 5-year National Surgical Quality Improvement Program Database Analysis

Bergstein,

O'Sullivan,

Levy

et al. 2024

JAAOS Glob Res Rev

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“…In a dynamic field where research findings are constantly unfolding, physicians on the front lines and their patients can potentially benefit from hospital infrastructure that supports the careful implementation of new findings. Though previous work has investigated how to lower complications from spine surgery, 10 , 11 this is the first study we know that has evaluated the effectiveness of a medication management support program like this one in a real-world hospital setting.…”

Section: Discussionmentioning

confidence: 99%

Reducing Surgical Complications in Spine Patients via a Medication Management Support Program

Balsis

Carello

Eskander

et al. 2023

Spine

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Study Design. A hospital-wide medication management program was implemented to ensure that high-risk patients would systematically pause antiplatelet and anticoagulant medications. We analyzed complications before and during the implementation of this program. Objective. The goal of the study was to determine if a medication management support program was effective for reducing perioperative complications, including hemorrhage, myocardial infarction, stroke, pulmonary embolism, and deep vein thrombosis. Data and Methods. Using data from the National Surgical Quality Improvement Program database, we examined the presence of 5 complications before and during the implementation of a medication management support program. There were 9732 patients in the clinic population who underwent elective spine surgery between 2011 and 2020 and were included in this analysis. Of those 9732 patients, 7205 had surgery before the introduction of the program, whereas 2527 had surgery at some point after the program was introduced. We conducted a series of Pearson’s χ2 tests to determine the relative frequencies of the complications before and during the program. Results. Results showed that during the implementation of the program, patients were relatively less likely to experience hemorrhage (3.16% vs. 1.11%; P<0.001). The reductions in thrombotic complications were clinically significant: myocardial infarction (0.12% vs. 0.00%), stroke (0.10% vs. 0.04%), pulmonary embolism (0.33% vs. 0.28%), and deep vein thrombosis (0.36% vs. 0.28%). These P values ranged from P=0.08 for myocardial infarction to P=0.67 for pulmonary embolism. Conclusions. The use of this medication management support program appears effective for reducing the need for blood transfusions and thrombotic complications. While promising, the results should be interpreted with caution as we do not know whether this type of program will be effective for other hospital systems.

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Venous Thromboembolic Issues

Parel,

Seibold,

Walker

et al. 2023

Lumbar Spine Access Surgery

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Venous thromboembolism and pulmonary embolism in spine surgery: Incidence, prevention, and management

Cited by 3 publications

References 44 publications

Racial Disparities in 30-day Readmission After Orthopaedic Surgery: A 5-year National Surgical Quality Improvement Program Database Analysis

Racial Disparities in 30-day Readmission After Orthopaedic Surgery: A 5-year National Surgical Quality Improvement Program Database Analysis

Reducing Surgical Complications in Spine Patients via a Medication Management Support Program

Venous Thromboembolic Issues

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