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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
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An Evidence-Based Algorithm for Determining Venous Thromboembolism Prophylaxis After Degenerative Spinal Surgery.
Joshua A Shapiro1, Matthew R Stillwagon1, Alexander G Padovano1
1University of North Carolina, Department of Orthopaedics, Chapel Hill, North Carolina.
International Journal of Spine Surgery
|September 28, 2020
Summary
A validated risk/benefit score effectively guides venous thromboembolism (VTE) prophylaxis in spinal surgery, balancing thrombotic and bleeding risks. This score helps prevent complications without overtreatment.
Area of Science:
- Spinal Surgery
- Vascular Surgery
- Medical Algorithms
Background:
- Venous thromboembolism (VTE) is a serious risk in adult degenerative spinal surgery.
- Current VTE prophylaxis lacks a standardized protocol, risking overtreatment and bleeding complications.
- A previously developed VTE Prophylaxis Risk/Benefit Score aims to balance thrombotic and hemorrhagic risks.
Purpose of the Study:
- To validate the VTE Prophylaxis Risk/Benefit Score for guiding VTE prophylaxis.
- To assess the score's effectiveness in adult degenerative spinal surgery.
- To compare complication rates based on prophylaxis strategies.
Main Methods:
- Prospective assignment of VTE Prophylaxis Risk/Benefit Scores and prophylaxis from 2016-2017.
- Retrospective evaluation of immediate and short-term complications.
- Statistical analysis using Fisher exact test and multinomial logistic regression (P < .05).
Main Results:
- 266 patients analyzed; 79.3% received mechanical prophylaxis, 20.7% combined.
- Low complication rates: VTE (0.38%), wound issues (2.26%), hematoma (0.75%).
- Chemoprophylaxis and aspirin use correlated with hemorrhagic complications; no persistent neurologic deficits from hematoma or PE.
Conclusions:
- The VTE Prophylaxis Risk/Benefit Score is effective for determining appropriate thromboprophylaxis.
- The score comprehensively addresses risks of thrombotic, wound, and bleeding complications.
- This validated tool aids in optimizing VTE prophylaxis in degenerative spinal surgery.
Keywords:
venous thromboembolismalgorithmchemical thromboprophylaxisdeep infection ratehemorrhagic complication ratemechanical thromboprophylaxisrisk-benefitwound complication rateMore Related Videos
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