Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis Journal Article
| Authors: | Zacharia, B. E.; Kahn, S.; Bander, E. D.; Cederquist, G. Y.; Cope, W. P.; McLaughlin, L.; Hijazi, A.; Reiner, A. S.; Laufer, I.; Bilsky, M. |
| Article Title: | Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis |
| Abstract: | Objective: 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. Methods: 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. Results: 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. Conclusions: 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. © AANS, 2017. |
| Keywords: | adolescent; adult; aged; aged, 80 and over; middle aged; retrospective studies; young adult; biomarkers; biological marker; incidence; risk factors; age factors; diagnostic imaging; oncology; retrospective study; risk factor; age; pulmonary embolism; blood; preoperative period; spinal neoplasms; motor activity; statistical model; ultrasonography, doppler; spinal metastasis; secondary; likelihood functions; venous thrombosis; deep venous thrombosis; very elderly; humans; human; male; female; doppler ultrasonography |
| Journal Title: | Journal of Neurosurgery: Spine |
| Volume: | 27 |
| Issue: | 2 |
| ISSN: | 1547-5654 |
| Publisher: | American Association of Neurological Surgeons |
| Date Published: | 2017-08-01 |
| Start Page: | 189 |
| End Page: | 197 |
| Language: | English |
| DOI: | 10.3171/2017.2.spine16861 |
| PUBMED: | 28574332 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 5 September 2017 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work