Jung Bongseok, Ngan Alex, Song Junho, Abbas Anas, Zappia Luke C, Fallon John, Katz Austen D, Hecht Andrew C, Silber Jeff, Verma Rohit, Virk Sohrab, Essig David
Department of Orthopaedic Surgery, Northwell Health Long Island Jewish Medical Center, New Hyde Park.
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.
Clin Spine Surg. 2025 Jun 18. doi: 10.1097/BSD.0000000000001858.
Retrospective cohort study.
This study aimed to (1) identify temporal trends in the rates of venous thromboembolism (VTE), deep vein thrombosis (DVT), pulmonary embolism (PE), and mortality between 2012 and 2021 and (2) evaluate independent predictors of VTE following elective cervical spine surgery.
Current literature regarding the incidence, trend, and predictors of VTE after cervical spine surgery is severely limited. The lack of published peer-reviewed data has contributed to the significant variability in thromboembolic prophylaxis practice in spine surgery.
The ACS-NSQIP database was queried to determine the annual incidences of VTEs, DVTs, PEs, and mortality in cervical spine operations between 2012 and 2021. Multivariate logistic regression models were constructed to evaluate the primary outcomes and identify significant predictors of VTE following cervical spine surgery.
A total of 91,025 patients were included in our study. Annual rates of VTE, DVT, PE, and mortality did not change (all P>0.10) across operation years. Multivariate regression analysis further demonstrated no significant difference in VTEs, DVTs, PEs, and mortality across operation years. Independent predictors of VTE included advanced age, black race, elevated BMI, increased operation time, length of hospital stay, nonhome discharge, history of COPD, functional dependence, and high INR. Protective factors of VTE included female sex, outpatient surgery, and nonsmokers in this cohort.
Rates of thromboembolic complications following elective cervical spine surgery have not improved over the last decade (2012-2021). Factors such as advanced age, black race, elevated BMI, increased operation time, length of hospital stay, nonhome discharge, history of COPD, functional dependence, and high preoperative INR values were independent predictors of VTEs, while female sex, no tobacco use, and outpatient surgery were found to be protective factors.
回顾性队列研究。
本研究旨在（1）确定2012年至2021年间静脉血栓栓塞症（VTE）、深静脉血栓形成（DVT）、肺栓塞（PE）的发生率及死亡率的时间趋势，以及（2）评估择期颈椎手术后VTE的独立预测因素。
目前关于颈椎手术后VTE的发生率、趋势和预测因素的文献非常有限。缺乏已发表的同行评审数据导致脊柱手术中血栓栓塞预防措施的显著差异。
查询美国外科医师协会国家外科质量改进计划（ACS-NSQIP）数据库，以确定2012年至2021年间颈椎手术中VTE、DVT、PE的年发生率及死亡率。构建多因素逻辑回归模型以评估主要结局，并确定颈椎手术后VTE的显著预测因素。
本研究共纳入91,025例患者。在各手术年份中，VTE、DVT、PE的年发生率及死亡率均无变化（所有P>0.10）。多因素回归分析进一步表明，各手术年份的VTE、DVT、PE及死亡率无显著差异。VTE的独立预测因素包括高龄、黑人种族、BMI升高、手术时间延长、住院时间、非家庭出院、慢性阻塞性肺疾病（COPD）病史、功能依赖和高国际标准化比值（INR）。在该队列中，VTE的保护因素包括女性、门诊手术和非吸烟者。
在过去十年（2012 - 2021年）中，择期颈椎手术后血栓栓塞并发症的发生率没有改善。高龄、黑人种族、BMI升高、手术时间延长、住院时间、非家庭出院、COPD病史、功能依赖和术前高INR值等因素是VTE的独立预测因素，而女性、不吸烟和门诊手术则是保护因素。
Zotero 插件