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BACKGROUND Few studies provide insight into risk factors (RFs) associated with postoperative deep vein thrombosis (DVT) following elective spinal surgery. DVTs are detrimental in this population due to the risk of pulmonary embolization or surgical site hemorrhage with treatment. OBJECTIVE Elective spine surgery patients have a low incidence of DVT, thus, a case-control study was selected to investigate RFs associated with postoperative symptomatic DVT. METHODS Cases were matched to controls in a 1:2 ratio based on surgery type. Risk of having a prior DVT and choice of subcutaneous heparin dosing following surgery was analyzed in a multivariate regression model with other potentially confounding variables. RESULTS 195 patients were included in this study. Independent of patient age, history of DVT was associated with postoperative symptomatic DVT (OR 4.09, 95% CI 1.22-13.78). Two versus three times daily postoperative heparin dosing (OR 1.56, 95% CI 0.32-7.56), surgery length (OR 1.32, 95% CI 0.98-1.79), and patient age (OR 1.04, 95% CI 1.0-1.08) were not statistically significant, independent RFs. Older age and longer length of surgery trended toward association with DVT without reaching significance. Length of stay (LOS) was increased from 3-5 days (P<0.001) in DVT patients compared to controls. CONCLUSIONS These results suggest that patients with a history of DVT undergoing elective spinal surgery are at higher risk of developing symptomatic DVT postoperatively resulting in significantly increased LOS. Further study on additional preoperative screening and medical optimization in elective spine surgery patients may help reduce the rate of symptomatic postoperative DVT.
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10.1016/j.wneu.2020.08.182
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Risk Factors Associated With Symptomatic Deep Vein Thrombosis Following Elective Spine Surgery: A Case Control Study.
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