Risk factors for deep vein thrombosis and pulmonary embolism in patients undergoing spinal fusion for adult spinal deformity.

Abstract

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are well-known contributors to morbidity and mortality following spine surgery. The aim of this study is to evaluate the risk factors for DVT and PE and the impact on outcomes in patients with adult spinal deformity (ASD). A retrospective cohort study was performed using the 2011-2022 ACS NSQIP database. Adults receiving corrective surgery for adult spinal deformity were identified using CPT and ICD codes. We compared patient demographics, comorbidities, and operation time between those with and without postoperative DVT or PE. We used multivariable logistic regression models to evaluate predictors for DVT/PE occurrence and the impact of DVT/PE on 30-day unplanned reoperation and 30-day mortality. Among the 4,469 patients studied, 143 (3.2%) had a 30-day postoperative occurrence of DVT/PE. There were 2,775 (62.1%) females, and 3,661 (81.9%) were non-Hispanic White. Multivariable analysis revealed age [aOR: 1.03, 95% CI: 1.01-1.04] and total operation time [aOR: 1.25, 95% CI: 1.18-1.33] as significant predictors of 30-day postoperative occurrence of DVT/PE. Occurrence of DVT/PE was significantly associated with higher odds of 30-day unplanned reoperation [OR: 2.43, 95% CI: 1.41-4.18] and 30-day mortality [OR: 5.97, 95% CI: 2.26-15.80]. Our study suggests that increasing age and total operation time are potential risk factors for 30-day postoperative DVT/PE in ASD patients; DVT/PE also independently predicted 30-day unplanned reoperation and mortality. Future studies should focus on further investigating the risk factors for DVT/PE in ASD patients undergoing PSF.