Incidence and Risk factors of Venous Thromboembolism in the Perioperative Period of Spine Surgery at a Tertiary Care Hospital

Abstract Introduction:Spine Surgery is considered a moderate risk for developing Venous Thromboembolism (VTE). To our knowledge, no study has been done to determine the incidence of VTE in our local population. We aim to study this and determine the factors associated with developing VTE post spine surgery. Material and Methods:A retrospective chart review was conducted to analyze 892 adult patients who underwent either an elective or emergency spine surgery. Demographics, length of surgery and hospital stay, diagnosis, and location of surgery in addition to the type of trauma, if applicable, were collected. Furthermore, spiral computed tomography was used to diagnose pulmonary embolism (PE), and duplex ultrasound was used to diagnose deep vein thrombosis (DVT) pre- and post-operatively. Results:800 patients were included. The overall incidence of VTE was 4.1%. In addition, Lumbar spine was the most common location operated on. Increasing age and length of hospital stay were both significantly associated with development of VTE. Furthermore, cervical spine surgery had a lower incidence of VTE compared to other locations which was statistically significant. Lastly, non-ambulatory patients had a higher risk of having VTE compared to patient who were able to ambulate post-operatively. Conclusion:The incidence of VTE after spine surgery is considered low but carries high rates of morbidity and mortality. Increased age and prolonged hospital stay increases its risk while early ambulation lowers it. Larger prospective study is needed to identify the best prophylactic anticoagulation regimen. Prophylactic measures against VTE are highly recommended, especially amongst high-risk patients. IRB approval:This study has been submitted and approved by the Institutional Review Board (IRB).