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 | |
dc.contributor.author | Diebo, BG | |
dc.contributor.author | Kelly, MP | |
dc.contributor.author | Sciubba, D | |
dc.contributor.author | Schwab, F | |
dc.contributor.author | Lafage, V | |
dc.contributor.author | Mundis, GM | |
dc.contributor.author | Shaffrey, CI | |
dc.contributor.author | Smith, JS | |
dc.contributor.author | Hart, R | |
dc.contributor.author | Burton, D | |
dc.contributor.author | Bess, S | |
dc.contributor.author | Klineberg, EO | |
dc.date.accessioned | 2023-07-08T12:45:10Z | |
dc.date.available | 2023-07-08T12:45:10Z | |
dc.date.issued | 2018-05-01 | |
dc.date.updated | 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 | |
dc.identifier.issn | 2192-5690 | |
dc.identifier.uri | ||
dc.language | en | |
dc.publisher | SAGE Publications | |
dc.relation.ispartof | Global Spine Journal | |
dc.relation.isversionof | 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 | |
pubs.organisational-group | School of Medicine | |
pubs.organisational-group | Clinical Science Departments | |
pubs.organisational-group | Orthopaedic Surgery | |
pubs.organisational-group | Neurosurgery | |
pubs.publication-status | Published | |
pubs.volume | 8 |
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