Abstract
Objective To analyze the independent risk factors for Deep Venous Thrombosis (DVT) in the lower limbs of patients after traumatic spinal fractures.
Methods The clinical data of 205 patients who underwent surgical treatment for traumatic spinal fracture due to high-energy injury in our hospital from September 2021 to February 2024 were retrospectively analyzed. Included patients were treated with low molecular weight heparin and mechanical prevention of DVT. Patients underwent ultrasound examination within 1 week after surgery and were divided into DVT group and non-DVT group.
Results The overall incidence of postoperative DVT was 26.9% (55/205). Proximal thrombus occurred in 3 patients (1.5%) and distal thrombus in 52 patients (25.4%). No patients developed pulmonary embolism. Binary Logistic analysis showed that age (OR= 1.120, P<0.001), D-dimer (OR=1.347, P=0.002), bed time (OR=1.313, P<0.001), hypoproteinemia (OR=14.380, P<0.001), Blood transfusion (OR=5.707, P=0.003) was an independent risk factor for postoperative DVT in patients with traumatic spinal fractures. The value of different risk factors in the diagnosis of postoperative DVT was analyzed by ROC curve. The AUC values of age, bed time, blood transfusion and hypoproteinemia were 0.734, 0.822, 0.760 and 0.777, respectively. The diagnostic value of D-dimer (AUC value =0.884) was the highest among these risk factors. The diagnostic cut-off value of postoperative D-dimer was determined by Jorden index to be 3.185mg/L.
Conclusions Despite chemical and mechanical prevention of DVT, the incidence of postoperative DVT remains high, with D-dimer>3.185mg/l on the first day after surgery, bed time, age, blood transfusion, and hypoproteinemia being independent risk factors for postoperative DVT in patients with traumatic spinal fractures.