Complications of Venous Thromboembolism Chemoprophylaxis in Lumbar Laminectomy With and Without Fusion

Article Figures & Data

Table 1

Demographics and surgical characteristics of patients who received chemoprophylaxis vs patients who did not.

Characteristics	Inpatient Chemoprophylaxis
Characteristics	No (n = 316)	Yes (n = 316)	P
Patient Demographics
BMI	28.55 ± 7.79	29.72 ± 6.69	0.042
CCI	4.25 ± 2.50	4.15 ± 2.37	0.567
Age, y	65.31 ± 11.78	66.44 ± 12.31	0.239
ASA grade	2.39 ± 0.57	2.57 ± 0.58	<0.001
Gender (% woman)	152 (48.1%)	133 (42.1%)	0.129
Race			0.863
White	203 (64.2%)	206 (65.2%)
African American	36 (11.4%)	30 (9.5%)
Asian	24 (7.6%)	27 (8.5%)
Other	53 (16.8%)	53 (16.8%)
Payor type (% private)	209 (66.1% )	197 (62.3%)	0.113
Surgical Characteristics
Fusion	213 (67.4%)	209 (66.1%)	0.736
Levels fused	0.97 ± 0.85	1.11 ± 1.01	0.056
Laminectomy upper vertebra	22.28 ± 1.02	22.25 ± 0.997	0.723
Laminectomy lower vertebra	23.93 ± 2.070	24.14 ± 1.58	0.447
MIS vs open (% open)	25 (7.9%)	14 (4.4%)	0.069
EBL, mL	237.22 ± 274.03	281.50 ± 310.92	0.058
Operative time, min	209.87 ± 86.32	213.37 ± 88.24	0.614
Intraoperative complications	14 (4.4%)	25 (7.9%)	0.069

Abbreviations: ASA, American Society of Anesthesiologists; BMI, body mass index; CCI, cranial cervical instability; EBL, estimated blood loss; MIS, minimally invasive surgery.
Note: Data presented as mean ± SD or n (%). Bolded values are statistically significant (P < 0.05).

Table 2

Hematoma/seroma development, I&D, and wound dehiscence in patients who received vs did not receive chemoprophylaxis.

Hematomas/Seromas, I&D, and Wound Dehiscence	Inpatient Chemoprophylaxis
Hematomas/Seromas, I&D, and Wound Dehiscence	No (n = 316)	Yes (n = 316)	P
All hematomas/seroma	4 (1.3%)	4 (1.3%)	>0.99
Superficial seromas/hematomas	1 (0.3%)	1 (0.3%)	>0.99
Deep seromas/hematomas	2 (0.6%)	3 (0.9%)	0.653
Canal/epidural hematomas	1 (0.3%)	0 (0.0%)	0.317
All hematomas/seromas diagnosis date (POD)	35.50 ± 33.56	37.67 ± 47.48	0.946
I&D procedure	2 (0.6%)	2 (0.6%)	>0.99
Date of I&D (POD)	37.00 ± 48.08	13.00 ± 11.31	0.563
Wound dehiscence	0 (0.0%)	0 (0.0%)	-
Moist wound or dressing	80 (25.3%)	125 (39.6%)	<0.001
Avg drain duration, d	3.77 ± 2.74	4.60 ± 1.953	<0.001
Avg daily drainage, mL	146.96 ± 96.35	157.64 ± 104.13	0.238

Abbreviations: I&D, incision and drainage; POD, postoperative day.
Note: Data presented as mean ± SD or n (%). Bolded values are statistically significant (P < 0.05).

Table 3

Rates of VTE, infection, and transfusions in patients who received vs did not receive chemoprophylaxis.

Rates of VTE, Infection, and Transfusions	Inpatient Chemoprophylaxis
Rates of VTE, Infection, and Transfusions	No (n = 316)	Yes (n = 316)	P
Postoperative transfusion	5 (1.6%)	12 (3.8%)	0.085
Intraoperative transfusion	6 (1.9%)	8 (2.5%)	0.589
VTE (%)	3 (0.9%)	8 (2.5%)	0.128
POD of first VTE diagnosis	18.33 ± 15.37	8.88 ± 7.51	0.469
All infections^{^a}	6 (1.9%)	9 (2.8%)	0.433
Superficial SSI	1 (0.3%)	3 (0.9%)	0.316
Deep SSI	6 (1.9%)	8 (2.5%)	0.589

Abbreviations: POD, postoperative day; SSI, surgical site infection; VTE, venous thromboembolism.
Note: Data presented as mean ± SD or n (%).
↵a Some patients had both superficial and deep SSIs.

Table 4

Rates of postoperative complications in patients who received vs did not receive chemoprophylaxis.

Postoperative Complications	Inpatient Chemoprophylaxis
Postoperative Complications	No (n = 316)	Yes (n = 316)	P
Overall rates	37 (11.7%)	70 (22.2%)	<0.001
Cardiac	6 (1.9%)	22 (7.0%)	0.002
Neurologic	9 (2.8%)	15 (4.7%)	0.212
Pulmonary	3 (0.9%)	6 (1.9%)	0.314
Airway edema	1 (0.3%)	0 (0.0%)	0.317
Ileus	3 (0.9%)	13 (4.1%)	0.011
Urinary	9 (2.8%)	13 (4.1%)	0.385
Death	0 (0.0%)	0 (0.0%)	-
Mechanical	0 (0.0%)	0 (0.0%)	-

Note: Data presented as mean ± SD or n (%). Bolded values are statistically significant (P < 0.05).

Table 5

Demographics and postoperative outcomes in patients on chemoprophylaxis who underwent laminectomy with fusion vs without fusion.

Demographics and Outcomes	Fusion
Demographics and Outcomes	No (n = 107)	Yes (n = 209)	P
Patient Demographics
BMI	29.94 ± 5.93	29.62 ± 7.06	0.669
CCI	4.79 ± 2.41	3.82 ± 2.28	0.001
Age, y	69.76 ± 13.37	64.74 ± 11.39	0.001
ASA grade	2.77 ± 0.592	2.46 ± 0.546	0.001
Female gender	28 (26.0%)	104 (50.0%)	0.001
Race			0.756
White	68 (63.6%)	138 (66.0%)
African American	10 (9.3%)	20 (9.6%)
Asian	9 (8.4%)	18 (8.6%)
Other	20 (18.7%)	33 (15.8%)
Payor type (% private)	58 (54.2%)	139 (66.5%)	0.036
Levels fused	0 ± 0	1.68 ± 0.763
MIS vs open laminectomy (% open)	1 (0.90%)	13 (6.20%)	0.006
EBL (mL)	163.64 ± 196.983	341.84 ± 340.332	0.001
Op time (min)	155.78 ± 66.097	242.86 ± 83.573	0.001
Postoperative Outcomes
Length of stay, d	3.50 ± 3.01	4.37 ± 2.42	0.011
Return to OR in 30 d	5 (4.7%)	3 (1.4%)	0.145
Return to OR in 90 d	1 (0.9%)	8 (3.8%)	0.076
Cardiac complications	3 (2.8%)	19 (9.1%)	0.015
Venous thromboembolism	7 (6.5%)	11 (5.3%)	0.353
All hematomas/seromas	0 (0.0%)	4 (1.9%)	0.045
Incision and drainage procedure	2 (1.9%)	0 (0.0%)	0.158
All infections	6 (5.6%)	3 (1.4%)	0.082

Abbreviations: ASA, American Society of Anesthesiologists; BMI, body mass index; CCI, cranial cervical instability; EBL, estimated blood loss; LOS, length of stay; MIS, minimally invasive surgery; OR, operating room; VTE, venous thromboembolism.
Note: Data presented as mean ± SD or n (%).