Clinically Significant Thromboembolic Disease in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 737 Patients

dc.contributor.author

Kim, HJ

dc.contributor.author

Iyer, S

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Diebo, BG

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Kelly, MP

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Sciubba, D

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Schwab, F

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Lafage, V

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Mundis, GM

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Shaffrey, CI

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Smith, JS

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Hart, R

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Burton, D

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Bess, S

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Klineberg, EO

dc.date.accessioned

2023-07-08T12:45:10Z

dc.date.available

2023-07-08T12:45:10Z

dc.date.issued

2018-05-01

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2023-07-08T12:45:10Z

dc.description.abstract

Study Design: Retrospective cohort study. Objectives: Describe the rate and risk factors for venous thromboembolic events (VTEs; defined as deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) in adult spinal deformity (ASD) surgery. Methods: ASD patients with VTE were identified in a prospective, multicenter database. Complications, revision, and mortality rate were examined. Patient demographics, operative details, and radiographic and clinical outcomes were compared with a non-VTE group. Multivariate binary regression model was used to identify predictors of VTE. Results: A total of 737 patients were identified, 32 (4.3%) had VTE (DVT = 14; PE = 18). At baseline, VTE patients were less likely to be employed in jobs requiring physical labor (59.4% vs 79.7%, P <.01) and more likely to have osteoporosis (29% vs 15.1%, P =.037) and liver disease (6.5% vs 1.4%, P =.027). Patients with VTE had a larger preoperative sagittal vertical axis (SVA; 93 mm vs 55 mm, P <.01) and underwent larger SVA corrections. VTE was associated with a combined anterior/posterior approach (45% vs 25%, P =.028). VTE patients had a longer hospital stay (10 vs 7 days, P <.05) and higher mortality rate (6.3% vs 0.7%, P <.01). Multivariate analysis demonstrated osteoporosis, lack of physical labor, and increased SVA correction were independent predictors of VTE (r2 =.11, area under the curve = 0.74, P <.05). Conclusions: The incidence of VTE in ASD is 4.3% with a DVT rate of 1.9% and PE rate of 2.4%. Osteoporosis, lack of physical labor, and increased SVA correction were independent predictors of VTE. Patients with VTE had a higher mortality rate compared with non-VTE patients.

dc.identifier.issn

2192-5682

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2192-5690

dc.identifier.uri

https://hdl.handle.net/10161/28331

dc.language

en

dc.publisher

SAGE Publications

dc.relation.ispartof

Global Spine Journal

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10.1177/2192568217724781

dc.title

Clinically Significant Thromboembolic Disease in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 737 Patients

dc.type

Journal article

duke.contributor.orcid

Shaffrey, CI|0000-0001-9760-8386

pubs.begin-page

224

pubs.end-page

230

pubs.issue

3

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

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Orthopaedic Surgery

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Neurosurgery

pubs.publication-status

Published

pubs.volume

8

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