Journal article
Chemoprophylaxis Timing Is Not Associated With Postoperative Bleeding After Spinal Trauma Surgery
Clinical neurology and neurosurgery, Vol.225, 107590
01/11/2023
DOI: 10.1016/j.clineuro.2023.107590
PMID: 36641991
Abstract
Little is known regarding appropriate timing for chemical venous thromboembolism (VTE) prophylaxis initiation in operative traumatic spinal injuries. We hypothesized that the incidence of post-operative bleeding leading to neurological decline or re-operation would not increase in patients who received early VTE prophylaxis (≤2 days post-surgery) as compared to those who received late VTE prophylaxis (≥ 3 days post-surgery).
This is a retrospective cohort study. Spine trauma patients who underwent spinal surgery, defined as anterior cervical discectomy and fusion, posterior cervical spinal fusion, anterior or posterior thoracic/lumbar spinal fusion, or vertebral percutaneous fixation from July 2015 to July 2020 were included. Demographics, pre-injury anti-thrombotics, operative characteristics, pre- and post-operative VTE prophylaxis, and post-operative complications, including spinal bleeding, and VTE were collected. Univariate analysis was performed, comparing baseline characteristics, VTE prophylaxis timing, and complications between the early and late groups.
Two-hundred-eighty-two patients were included; 189 were in the early group (1.7 ± 0.5 days), and 93 were in the late (4.4 ± 2.1 days) group. The late group received enoxaparin more often than patients in the early group (41.9 % vs. 19 %, p < 0.001). Baseline characteristics, hospital course, and surgical management were similar between the groups. The rate of post-operative complications, including hematoma and VTE was similar between the groups. None of the patients in the early group had post-operative bleeding.
In this retrospective cohort study, VTE prophylaxis timing was not associated with clinically significant post-operative spinal bleeding and VTE in trauma patients.
Details
- Title: Subtitle
- Chemoprophylaxis Timing Is Not Associated With Postoperative Bleeding After Spinal Trauma Surgery
- Creators
- Carine Dornbush - University of IowaConnor Maly - University of IowaNicholas Bartschat - Roy J. and Lucille A. Carver College of MedicineMichele Lilienthal - University of IowaColette Galet - University of IowaDionne A Skeete - Division of Acute Care Surgery, Department of Surgery, University Iowa, IA 52242, USA. Electronic address: dionne-skeete@uiowa.edu.Cassim Igram - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.225, 107590
- DOI
- 10.1016/j.clineuro.2023.107590
- PMID
- 36641991
- NLM abbreviation
- Clin Neurol Neurosurg
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Language
- English
- Date published
- 01/11/2023
- Academic Unit
- Orthopedics and Rehabilitation; Surgery; Injury Prevention Research Center
- Record Identifier
- 9984359708002771
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