Key result
Major spine surgery without routine thromboprophylaxis yields ~0.8% incidence of clinically evident DVT and no PE.
Why the study?
The incidence of deep vein thrombosis and pulmonary embolism after major spine surgery without any mechanical or chemical prophylaxis was uncertain.
Does early mobilization without mechanical or chemical prophylaxis prevent DVT and PE in patients undergoing major spine surgery?
Cohort (n=121)
No
Does early mobilization without mechanical or chemical prophylaxis prevent DVT and PE in patients undergoing major spine surgery?
Routine screening and prophylaxis for DVT appears unwarranted in major spine surgery due to a very low natural incidence of DVT and PE in this population.
Early mobilization without prophylaxis was associated with low VTE rates in this cohort; leaves open whether routine prophylaxis can be safely omitted.
STUDY DESIGN: Retrospective cohort study. CLINICAL QUESTION: What is the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) after major spine surgery when no prophylactic measures were used? METHODS: A prospective evaluation of 121 patients who underwent 128 major spine surgeries was conducted to determine the incidence of clinically identifiable DVT. As a matter of practice, no patient was given thromboprophylaxis, either mechanical or chemical. RESULTS: Only one patient developed the signs and symptoms of DVT, which was further confirmed by a Doppler study. The overall incidence of DVT was 0.78%. There was no clinically evident case of PE. CONCLUSIONS: Considering the low rate of incidence of DVT and PE, routine screening and prophylaxis for DVT appears unwarranted in major spine surgery. [Table: see text].
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Sreedharan PE Namboothiri (2013) conducted a cohort in Major spine surgery (n=121). No thromboprophylaxis (early mobilization only) was evaluated on Incidence of clinically identifiable deep vein thrombosis (DVT) and pulmonary embolism (PE). In patients undergoing major spine surgery without mechanical or chemical prophylaxis, the overall incidence of clinically identifiable DVT was 0.78%, with no clinically evident cases of PE.
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