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

Publication ,  Journal Article
Kim, HJ; Iyer, S; Diebo, BG; Kelly, MP; Sciubba, D; Schwab, F; Lafage, V; Mundis, GM; Shaffrey, CI; Smith, JS; Hart, R; Burton, D; Bess, S ...
Published in: Global Spine Journal
May 1, 2018

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.

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Published In

Global Spine Journal

DOI

EISSN

2192-5690

ISSN

2192-5682

Publication Date

May 1, 2018

Volume

8

Issue

3

Start / End Page

224 / 230

Related Subject Headings

  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kim, H. J., Iyer, S., Diebo, B. G., Kelly, M. P., Sciubba, D., Schwab, F., … Klineberg, E. O. (2018). Clinically Significant Thromboembolic Disease in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 737 Patients. Global Spine Journal, 8(3), 224–230. https://doi.org/10.1177/2192568217724781
Kim, H. J., S. Iyer, B. G. Diebo, M. P. Kelly, D. Sciubba, F. Schwab, V. Lafage, et al. “Clinically Significant Thromboembolic Disease in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 737 Patients.” Global Spine Journal 8, no. 3 (May 1, 2018): 224–30. https://doi.org/10.1177/2192568217724781.
Kim HJ, Iyer S, Diebo BG, Kelly MP, Sciubba D, Schwab F, et al. Clinically Significant Thromboembolic Disease in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 737 Patients. Global Spine Journal. 2018 May 1;8(3):224–30.
Kim, H. J., et al. “Clinically Significant Thromboembolic Disease in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 737 Patients.” Global Spine Journal, vol. 8, no. 3, May 2018, pp. 224–30. Scopus, doi:10.1177/2192568217724781.
Kim HJ, Iyer S, Diebo BG, Kelly MP, Sciubba D, Schwab F, Lafage V, Mundis GM, Shaffrey CI, Smith JS, Hart R, Burton D, Bess S, Klineberg EO. Clinically Significant Thromboembolic Disease in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 737 Patients. Global Spine Journal. 2018 May 1;8(3):224–230.
Journal cover image

Published In

Global Spine Journal

DOI

EISSN

2192-5690

ISSN

2192-5682

Publication Date

May 1, 2018

Volume

8

Issue

3

Start / End Page

224 / 230

Related Subject Headings

  • 3202 Clinical sciences