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RISK FACTORS FOR VENOUS THROMBOEMBOLISM IN PATIENTS WITH UNCOMPLICATED THORACOLUMBAR SPINE INJURY


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Abstract

Background. Venous thromboembolism (VTE) is the most formidable and often tragic emergency situation developing in surgical patients. The question of incidence and risk factors for the development of VTE in patients with spine trauma is insufficiently studied. Purpose of the study: to analyze risk factors for the development of venous thromboembolism (VTE) in patients after spinal surgery for uncomplicated thoracolumbar spine injury. Material and Methods. A retrospective analysis of the surgical treatment data of 117 patients aged 23 to 65 years, concerning uncomplicated thoracolumbar spine injury, in the period from 2014 to 2016 had been performed. All patients underwent ultrasonography of the veins of the lower extremities and the level of D-dimer in the blood was determined by the enzyme immunoassay. In order to identify and assess the impact of various risk factors for the development of VTE in patients with uncomplicated spine injury, general indicators, features of surgical intervention and postoperative period, as well as the somatic status of patients were taken into account. Results. The prevalence of VTE in the postoperative period was 19.6% (n = 23). At the same time, 22 patients with VTE were asymptomatic. The analysis of the influence of various indicators on the risk of VTE development showed that the following indicators significantly influence: ASA risk level (odds ratio (OC) 4.174, 95% confidence interval (95% CI) 1.572-13.185), age (OR 4.658, 95% CI 1.476-14.569), as well as late activation of the patient (OR 1.043, 95% CI 1.003-1.088). Conclusion. The prevalence of VTE after spinal surgery for uncomplicated thoracolumbar spine injury was 19.6%, with most of these complications being asymptomatic. In turn, the prevalence of thromboembolism of pulmonary arteries was 0.8% of cases. The following indicators have a significant influence on the development of VTE: the degree of risk on the ASA scale, age and late activation of the patient.


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