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

Brad E. Zacharia, Sweena Kahn, Evan D. Bander, Gustav Y. Cederquist, William P. Cope, Lily McLaughlin, Alexa Hijazi, Anne S. Reiner, Ilya Laufer, Mark Bilsky

Research output: Contribution to journalArticle

12 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)189-197
Number of pages9
JournalJournal of Neurosurgery: Spine
Volume27
Issue number2
DOIs
StatePublished - Aug 2017

All Science Journal Classification (ASJC) codes

  • Surgery
  • Neurology
  • Clinical Neurology

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    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. (2017). Incidence and risk factors for preoperative deep venous thrombosis in 314 consecutive patients undergoing surgery for spinal metastasis. Journal of Neurosurgery: Spine, 27(2), 189-197. https://doi.org/10.3171/2017.2.SPINE16861