Frequency and Associated Factors of Venous Thromboembolism in Cervical Spine Surgery

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A cut-off value for 1-wk postoperative D-dimer level of 6.2 μg/mL provided a sensitivity of 88.9% and specificity of 93.4% for identifying venous thromboembolism occurrence. Abbreviation: AUC, area under the receiver operating characteristic curve.

Table 1

Patient characteristics and operative details by group.

Characteristics	VTE group (N = 9)	Non-VTE group (N = 324)	P
Gender, men:women	6:3	227:97	>0.99
Age, y, mean ± SD	79.6 ± 9.7	67.7 ± 13.5	<0.01
Disease			0.54
Cervical spondylotic myelopathy	7	166
Herniated disc	0	15
Tumor	1	16
Atlantoaxial subluxation	0	16
Pseudotumor	0	10
Cervical spondylotic amyotrophy	0	32
Ossification of the posterior longitudinal ligament	0	49
Other	1	20
Preoperative Japanese Orthopedic Association score	7.0 ± 6.9	10.6 ± 3.5	0.46
Surgical procedure
Fusion, n (%)	4 (44.4%)	131 (40.4%)	>0.99
Fused vertebral levels, mean ± SD	3.7 ± 4.5	1.8 ± 2.6	0.24
Surgical time, min, mean ± SD	228 ± 101	167 ± 85	0.10
Blood loss volume, mL, mean ± SD	259 ± 306	119 ± 147	0.20
Preoperative D-dimer, μg/mL, mean ± SD	7.9 ± 12.4	1.1 ± 1.2	0.14
Postoperative D-dimer, μg/mL, mean ± SD	10.6 ± 4.4	2.7 ± 2.1	<0.01
Diabetes mellitus, n (%)	3 (33.3%)	63 (19.4%)	0.38
Hypertension, n (%)	3 (33.3%)	106 (32.7%)	>0.99
Rheumatoid arthritis, n (%)	1 (11.1%)	11 (3.3%)	0.28
Cardiovascular disease, n (%)	4 (44.4%)	36 (11.1%)	0.011
Atrial fibrillation, n (%)	1 (11.1%)	8 (2.4%)	0.21
Coronal artery disease, n (%)	2 (22.2%)	16 (4.8%)	0.076
Heart failure, n (%)	0 (0%)	5 (1.5%)	>0.99
Cancer, n (%)	1 (11.1%)	27 (8.3%)	0.55
Dialysis, n (%)	1 (11.1%)	7 (2.1%)	0.19

Table 2

Effects of patient-related factors on venous thromboembolism.

Factor	Univariate		Multivariate
Factor	OR (95% CI)	P	OR (95% CI)	P
Age (+1 y)	2.91 (1.27–6.70)	0.011	1.85 (0.73–4.66)	0.18
Women	1.17 (0.28–4.77)	0.82
Preoperative Japanese Orthopedic Association score	0.76 (0.55–1.55)	0.096
Fusion	1.18 (0.31–4.47)	0.80
Fused vertebral levels	1.21 (1.00–1.46)	0.047	1.25 (0.97–1.60)	0.080
Surgical time	1.01 (1.00–1.01)	0.043
Blood loss volume	1.00 (1.00–1.01)	0.015
Preoperative D-dimer	1.61 (1.25–2.07)	<0.01	1.20 (0.94–1.52)	0.14
Postoperative D-dimer	1.60 (1.33–1.92)	<0.01	1.54 (1.23–1.94)	<0.01
Diabetes mellitus	2.07 (0.50–8.51)	0.31
Hypertension	1.03 (0.25–4.19)	0.96
Rheumatoid arthritis	3.56 (0.40–31.0)	0.25
Cardiovascular disease	6.40 (1.64–24.9)	<0.01	9.52 (1.08–84.0)	0.042
Cancer	1.37 (0.16–11.4)	0.76
Dialysis	5.66 (0.62–51.6)	0.12

Table 3

Comparisons between anterior and posterior surgery cases.