| Objective:Patients with spinal fractures have a significantly increased risk of VTE compared to other patients undergoing spinal surgery,but the risk factors for VTE are still unclear.This retrospective study was intended to explore the risk factors for VTE in patients with spinal fractures.Methods:The spinal fractures cases from January 2018 to February 2020,Zhejiang university affiliated Sir Run Run hospital are collected to the observation samples.Inclusion criteria: 1.Admission of patients with spinal fractures requires spinal surgery;2.Length of stay is greater than or equal to 48 h.Exclusion criteria: 1.Removal of internal fixation after spinal fracture surgery.2.Venous thrombosis was diagnosed before admission.The diagnosis of deep vein thrombosis and PTE was based on the2018-edition Chinese guidelines for pulmonary embolism.Then we make statistical analysis of the basic information of these patients such as age,gender,BMI smoking,history of drinking,foundation consolidation conditions like arrhythmia,hypertension,diabetes and surgical information like the bleeding during the operation and so on,to explore the characteristics of patients with VTE.Univariate analysis and logistic regression were used to analyze the risk factors of VTE in patients with spinal fractures.Results:According to the above screening criteria,a total of 360 patients were included,including 162 males(45.2%)and 198 females(54.8%).All patients are divided into thrombus group and control group by whether thrombosis occurs,among those a total of22 patients developed venous thromboembolism after admission,accounted for 6.1% of the total number.17 cases(77.3%)developed muscle calf vein thrombosis of lower limb,1 with popliteal vein thrombosis,4 with posterior tibial vein thrombosis and no patients developed pulmonary embolism.There are 27.3% of the patients on the remaining part of the spine fractures,27.3% of patients suffered spinal cord injury.The mean age of the thrombus group was 68.6±10.1 years old,with a BMI of 23.78±9.54 kg/m2,and that of the control group was 63.3±16.4 years old,with a BMI of 22.99±4.25 kg/m2.The caprini score of the thrombus group was significantly higher than that of the control group(7.3±3.4 VS 4.7±2.3).According to the time of thrombosis,the patients were divided into preoperative thrombus group and postoperative thrombus group.The ICU occupancy rate of patients with spinal fractures combined with VTE was 18.2 %,significantly higher than that of the control group,and the length of stay was prolonged(18.0±11.5 days VS 10.9±8.8 days),and the intraoperative blood loss increased(189.27±288.0ml VS 88.6±196.7ml),and the rate of intraoperative blood transfusion also increased.In all the patients with VTE,thrombosis occurred in a total of 12 cases after the operation,the average thrombosis time is 2(1,3)days after surgery,the preoperative DDI is obviously higher than patients without thrombosis(4.61±2.80 vs2.30±2.14 ug/ml,while the there is no significant statistical differences in proportion of prevention,prevention methods,the operation time,intraoperative blood loss and nosignificant difference,postoperative DDI(D dimer)between these two groups.Conclusion:Patients with spinal fractures have a higher risk of VTE during hospitalization,and the use of caprini score for VTE risk assessment is recommended for surgical patients upon admission.Significantly increased preoperative DDI was an independent risk factor for postoperative VTE in patients with spinal fractures. |
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