Venous thromboembolism and prophylaxis therapy after elective spine surgery: a population-based study.

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Megan FiasconaroStavros G Memtsoudis

Abstract

Currently, there is no generalized consensus regarding perioperative prophylaxis of venous thromboembolism (VTE) in patients undergoing spine surgery. In the absence of large-scale studies, we aimed to use national data to study the association between anticoagulant prophylaxis and VTE in spine surgical patients. Our secondary outcomes were hematoma and blood transfusion. We included anterior cervical discectomy and fusion (ACDF) and posterior lumbar fusion (PLF) cases from 2006 to 2016 recorded in the Premier Healthcare database. Anticoagulant prophylaxis was categorized into aspirin, regular heparin, and low molecular weight heparin given on the day of surgery. Mixed-effects models measured the association between anticoagulation categories and outcomes. Cohorts were adjusted to reduce the risk of "confounding by indication" and to distinguish between prophylactic and therapeutic use of anticoagulants. We report odds ratios (OR) and Bonferroni-corrected confidence intervals (CI). Among 83,839 individuals undergoing ACDF and PLF, 0.45% (n = 374) had a hematoma, 8.1% (n = 6,769) received a blood transfusion, and 0.13% (n = 113) experienced VTE. After adjustment for relevant covariates, prophylactic aspirin (OR, 1.48; CI, 1.17 t...Continue Reading

References

Jun 30, 2006·Yonsei Medical Journal·Seong YiHyun Chul Shin
Jan 31, 2009·Spine·Michael P GlotzbeckerMitchell B Harris
May 26, 2018·Global Spine Journal·Han Jo KimUNKNOWN International Spine Study Group (ISSG)
Jun 6, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Christopher K KeplerAlexander Vaccaro
Jan 15, 2020·Global Spine Journal·Anthony M AlvaradoPaul M Arnold
May 2, 2020·International Journal of Spine Surgery·Zachary SanfordChad M Patton

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