Risk Factors for Venous Thrombosis after Spinal Surgery: A Systematic Review and Meta-analysis

Abstract

Background. Venous thrombosis, comprising DVT and PE, is an orthopedic condition that may be fatal after surgery. This study’s purpose was to analyze risk factors for venous thrombosis following spine surgery to help guide treatment prophylaxis. Methods. A computer searched English databases such as PubMed, Web of Science, Embase, Cochrane Library, and Google Academic for relevant publications after spinal surgery. Preoperative walking difficulties, hypertension, diabetes, heart disease, preoperative bleeding volume, etc., were all examined using the NOS scale. Data were analyzed using Review Manager 5.3 software. An analysis was done. Due to the study’s differences, the data was compiled using fixed effects or random effects models. Results. A total of 25 studies were considered, with a total of 1,927,781 individuals after spine surgery, including 7843 patients with venous thrombosis. The included literatures had NOS scores ranging from 5 to 8. According to the findings of the meta-analysis, the age of patients with venous thrombosis after spinal surgery ( $\text{OR}=7.53$ , 95% CI (6.73, 8.33)), blood loss ( $\text{OR}=-141.79$ , 95% CI (-154.68, -128.9), $P=0.00001$ ), and operation time ( $\text{OR}=76.93$ , 95% CI (73.17, 80.86), $P=0.00001$ ) were higher than those without; diabetes mellitus (OR =1.23, 95% CI (1.12, 1.34), $P=0.00001$ ) and walking disability history ( $\text{OR}=2.97$ , 95% CL (1.77, 4.98), $P=0.0001$ ) increased the incidence of postoperative venous thrombosis. Conclusion. High age, female, spinal fusion, big volume blood loss patients, operation time, and hypertension, diabetes, and walking issue are all risk factors for venous thrombosis following surgery.