Investigation of Venous Thromboembolism Prophylaxis Practices in Spinal Fusion Surgery and Outcomes: A Single Center Experience

Abstract

Abstract Aim: Venous thromboembolism (VTE) is among the most common causes of preventable hospital-acquired deaths. VTE is known as deep vein thrombosis (DVT) when it occurs in the veins and pulmonary embolism (PE) when it occurs in the lungs and is common in surgery practice. We aimed to determine the frequency of venous thromboembolism (VTE), the factors affecting the development of VTE, and the types and effectiveness of VTE prophylaxis applications in patients who underwent spinal fusion surgery (SFS). Material and Methods: The patients aged over 18 who underwent SFS for spinal fracture or thoracolumbar stenosis in our neurosurgery clinic between June, 2020 and December, 2022 were included. The patients records were evaluated retrospectively. VTE prophylaxis was given according to the Caprini risk score. Results: A total of 137 patients, 85 (62%) of female, with a meanage of 48.6±+8.77 years were included in the study. According to the Caprini risk scores, 90 (65.7%) of the cases were at high risk. VTE was detected in four patients (2.9%) despite prophylaxis (3 cases of DVT and one pulmonary embolism). Conclusions: Although VTE prophylaxis is performed according to Carpini risk score in SFS, it is seen that embolisms cannot be prevented sufficiently. Therefore, studies with a high level of evidence are needed for the use of these algorithms in SFS.

Keywords

• Caprini score
• Prophylaxis
• Spinal Fusion Surgery
• Venous Thromboembolism

Spinal Füzyon Cerrahisinde Venöz Tromboemboli Profilaksisi Uygulamalarının ve Sonuçlarının İncelenmesi: Tek Merkez Deneyimi

Abstract

Öz Amaç: Venöz tromboembolizm (VTE), önlenebilir hastane kaynaklı ölümlerin en yaygın nedenlerinden biridir. VTE, damarlarda meydana geldiğinde derin ven trombozu (DVT), akciğerlerde meydana geldiğinde pulmoner emboli (PE) olarak bilinir ve cerrahi pratikte sık görülür. Spinal füzyon cerrahisi (SFS) uygulanan hastalarda venöz tromboembolizm (VTE) sıklığını, VTE gelişimini etkileyen faktörleri ve VTE profilaksisi uygulamalarının türlerini ve etkinliğini belirlemeyi amaçladık. Gereç ve Yöntem: Nöroşirürji kliniğimizde Haziran 2020 ile Aralık 2022 tarihleri arasında omurga kırığı veya torakolomber darlık nedeniyle SFS uygulanan 18 yaş üstü hastalar dahil edildi. Hasta kayıtları retrospektif olarak değerlendirildi. Caprini risk skoruna göre VTE profilaksisi verildi. Bulgular: Çalışmaya ortalama yaşları 48.6±+8.77 olan 85'i (%62) kadın olmak üzere toplam 137 hasta dahil edildi. Caprini risk skorlarına göre olguların 90'ı (%65,7) yüksek riskli idi. Profilaksiye (3 DVT ve 1 pulmoner emboli) rağmen dört hastada (%2,9) VTE saptandı. Sonuç: SFS'de VTE profilaksisi Carpini risk skoruna göre yapılmasına rağmen embolilerin yeterince önlenemediği görülmektedir. Bu nedenle bu algoritmaların SFS'de kullanımı için kanıt düzeyi yüksek çalışmalara ihtiyaç vardır.

Keywords

• Caprini skoru
• Profilaksi
• Spinal Füzyon Cerrahisi
• Venöz Tromboembolizm

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