Incidence and risk factors of venous thromboembolism in the perioperative period of spine surgery at a tertiary care hospital

Abstract

Objectives: Spine surgery is considered a moderate risk for developing venous thromboembolism (VTE). To the best of our knowledge, no study has been done to determine the incidence of VTE in our local population. We aimed to study the incidence of VTE and determine the factors associated with developing VTE post-spine surgery. Methods: A retrospective study analyzed 800 adult patients who had undergone elective or emergency spine surgery. The variables included were demographic data, diagnosis, “or trauma if applicable,” type and duration of surgical intervention, and length of hospital stay. In addition, two procedures were used to diagnose VTE, whether it was a pulmonary embolism (PE) or deep vein thrombosis (DVT) pre- and postoperatively. Spiral computed tomography was used to detect PE, whereas duplex ultrasonography was used to confirm DVT. Finally, all patients received post-operative DVT prophylaxis except for cervical spine patients. Results: Eight hundred patients were included in the study. The overall incidence of VTE was 4.1%. The lumbar spine was the most common location operated on. Increasing age and length of hospital stay were both significantly associated with the development of VTE. Furthermore, cervical spine surgery had a lower incidence of VTE than other locations, with a statistically significant difference. Finally, non-ambulatory patients had a higher risk of VTE than patients who could ambulate postoperatively, with a statistically significant difference. Conclusion: The incidence of VTE after spine surgery is considered low but carries high morbidity and mortality rates. Increased age and prolonged hospital stay increase its risk, while early ambulation lowers it. Prophylactic measures against VTE are highly recommended, especially amongst high-risk patients.