Risk Factors for Venous Thromboembolism Following Surgery for Thoracolumbar Fractures

Retrospective cohort study.

To identify risk factors for venous thromboembolism (VTE) following operative intervention for thoracolumbar (TL) fractures.

VTE is a common complication following spine surgery. However, there is a paucity of literature focusing on risk factors for VTE in patients undergoing operative intervention for TL fractures.

The TriNetX research database was queried to identify patients undergoing operative intervention for TL fractures between 2016 and 2024. Chi-square for categorical values and Student's t-test for continuous variables were performed on demographic variables and preoperative comorbidities. Multivariable logistic regression analysis with restricted cubic splines for age and body mass index was performed to identify independent risk factors for VTE within 90 days postoperatively.

A total of 4737 patients undergoing operative intervention for TL fractures were identified between 2016 and 2024, of whom 192 (4.1%) developed VTE and 4545 (95.9%) did not. Patients who developed VTE had a significantly higher prevalence of concurrent femur fractures (2.6% vs. 0.8%; P=0.044), surgical complications (3.6% vs. 1.0%; P=0.002), and major medical complications (40.1% vs. 21.0%; P<0.001). After adjustment, male sex (OR: 1.767; 95 CI [1.266-2.506]; P<0.001), preoperative anemia (OR: 3.035; 95 CI [2.130-4.274]; P<0.001), congestive heart failure (OR: 1.632; 95 CI [1.042-2.511]; P<0.001), osteoporosis (OR: 1.671; 95 CI [1.065-2.563]; P=0.022), and femur fracture (OR: 1.2.752; 95 CI [1.001-6.767]; P=0.044) independently increased the risk for VTE within 90 days following a TL fracture.

Male sex, preoperative anemia, congestive heart failure, osteoporosis, and concurrent femur fracture were identified as independent risk factors for the development of VTE following operative intervention for TL fractures. These findings may improve stratification of VTE risk in this population.