title: Predictable factors of deep venous thrombosis in patients undergoing spine surgery.
abstract: BACKGROUND
  DVT is one of the major postoperative complications of joint replacement surgery of the lower extremity which can cause catastrophic complications such as pulmonary embolism. However, little is known about the incidence of DVT after spine surgery. The purpose of this study was to examine predictable factors of DVT after spine surgery.
  
  
  METHODS
  This study included 194 patients who underwent spine surgery (104 males, 90 females, mean age 65.7 years). Postoperative DVT was detected using duplex ultrasonography (DUS). Age, sex, BMI, operation time, amount of bleeding, preoperative ambulatory status, usage of instrumentation, and preoperative serum levels of D-dimer were compared between the DVT(+) and DVT(-) groups to establish predictors for postoperative DVT. Cut-off value of the preoperative level of D-dimer was calculated using ROC analysis.
  
  
  RESULTS
  Postoperative DVT was detected in 57 patients (29.4%). No patients showed clinical signs of DVT or pulmonary embolism. Sex, age, BMI, preoperative non-ambulatory status, and preoperative levels of D-dimer were significantly different between the DVT(+) and DVT(-) groups. However, age and BMI was not significantly different factor in logistic regression analysis. Cut-off value of preoperative D-dimer was 1.4 μg/ml.
  
  
  CONCLUSIONS
  It was suggested that perioperative application of DUS for detecting DVT in the lower extremities should be performed on patients undergoing spine surgery who are female, non-ambulatory, and with higher preoperative D-dimer serum level.
authors.affiliation: Department of Orthopaedic Surgery, Kindai University Hospital, 377-2 Ohnohigashi, Osaka-Sayama, 589-8511, Osaka, Japan. Electronic address: tikeda@med.kindai.ac.jp.
authors.forename: Terumasa
authors.initials: T
authors.lastname: Ikeda
authors.affiliation: Department of Orthopaedic Surgery, Kindai University Hospital, 377-2 Ohnohigashi, Osaka-Sayama, 589-8511, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Miyamoto
authors.affiliation: Department of Orthopaedic Surgery, Kindai University Hospital, 377-2 Ohnohigashi, Osaka-Sayama, 589-8511, Osaka, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Hashimoto
authors.affiliation: Department of Orthopaedic Surgery, Kindai University Hospital, 377-2 Ohnohigashi, Osaka-Sayama, 589-8511, Osaka, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Akagi
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015331:Cohort Studies; D017586:Diskectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D015994:Incidence; D007796:Laminectomy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D