Lower-limb deep-vein thrombosis in a general hospital: risk factors, outcomes and the contribution of intravenous drug use

Lower limb deep vein thrombosis (DVT) is not an uncommon postoperative complication of spinal fusion surgery. However, the related risk factors identified in previous studies remain controversial. This study aimed to investigate risk factors for lower limb DVT in patients with single-level lumbar fusion surgery. Between January 2010 and December 2016, a total of 710 patients undergoing lumbar fusion were recruited for this study, including 172 males and 538 females (aged 18-75 years). Deep vein thrombosis was detected by ultrasonography. Accordingly, patients were divided into the DVT group and the non-DVT group and compared in terms of operative data, underlying diseases, and biochemical data. Additionally, logistic regression analysis was performed to identify risk factors for lower limb DVT. The incidence of lower limb DVT was 11.8% (84 of 710 cases). Five patients were symptomatic, with lower limb pain and swelling. Two patients developed pulmonary embolism and 1 died. Binary logistic regression indicated that advanced age ( P = .001, odds ratio [OR] = 2.86, 95% CI: 1.85-5.12), hypertension ( P = .006, OR = 4.10, 95% CI: 1.09-2.30), and increased d-dimer ( P < .001, OR = 3.49, 95% CI: 2.05-6.36) were risk factors for postoperative DVT. In conclusion, for patients with single-level lumbar fusion, advanced age, increased d-dimer, and hypertension may contribute to DVT development after spinal fusion surgery. Therefore, patients with these risk factors should be protected during the perioperative period.

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Analysis of risk factors for lower limb deep vein thrombosis in patients after Lumbar Fusion Surgery

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.1.3041 ◽

2020 ◽

Vol 37 (1) ◽

Author(s):

Qiang Li ◽

Zongxue Yu ◽

Xiao Chen ◽

Wenli Zhang

Keyword(s):

Risk Factors ◽

Deep Vein Thrombosis ◽

Lower Limb ◽

Lumbar Fusion ◽

Fusion Surgery ◽

Vein Thrombosis ◽

Prophylactic Measures ◽

Deep Vein ◽

Limb Deep Vein Thrombosis ◽

D Dimer

Objective: To identify the risk factors of deep vein thrombosis (DVT) of lower limb in patients undergoing lumbar fusion surgeries, to provide a better understanding of DVT and take prophylactic measures. Methods: This study was carried out in our hospital between January 2016 and February 2020, patients undergoing lumbar fusion surgeries were included and divided into DVT group and non-DVT group, and the medical data including basic demographics, clinical characteristics, operative data, and routine biochemical parameters were collected and analyzed. Results: In the current study, 390 cases were included, 48 cases were enrolled in DVT group and 342 in non-DVT group. The incidence of DVT was 12.3%. There were significant differences in age, hyperlipemia, hypertension, occupation type, D-dimer level, hospital stay, and postoperative exercises (p<0.05), but no significant differences in gender, smoking status, drinking status, coronary heart disease, diabetes mellitus, fused segments, and operation time (p>0.05) between the two groups. In multivariate analysis, age>50 years, hypertension, D-dimer>500ug/L were independent risk factors, while postoperative exercises were protective factor for DVT. Conclusion: Those patients undergoing lumbar fusion surgeries should take more prophylactic measures including postoperative exercises if they were elderly, or hypertensive, or have high D-dimer level, in order to decrease the incidence of DVT. doi: https://doi.org/10.12669/pjms.37.1.3041 How to cite this:Li Q, Yu Z, Chen X, Zhang W. Analysis of risk factors for lower limb deep vein thrombosis in patients after Lumbar Fusion Surgery. Pak J Med Sci. 2021;37(1):239-243. doi: https://doi.org/10.12669/pjms.37.1.3041 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abdominal aortic and iliac aneurysm presented as lower limb deep vein thrombosis: case report

Acta Chirurgica Belgica ◽

10.1080/00015458.2018.1538282 ◽

2018 ◽

Vol 120 (4) ◽

pp. 271-273

Author(s):

Vedran Pazur ◽

Inga Dakovic Bacalja ◽

Ivan Cvjetko ◽

Ana Borovecki

Keyword(s):

Deep Vein Thrombosis ◽

Case Report ◽

Lower Limb ◽

Iliac Aneurysm ◽

Vein Thrombosis ◽

Abdominal Aortic ◽

Deep Vein ◽

Limb Deep Vein Thrombosis

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A comparative study of colour doppler findings in diabetic and non-diabetic lower limb deep vein thrombosis patients attending tertiary care hospital

International Journal of Radiology and Diagnostic Imaging ◽

10.33545/26644436.2020.v3.i1d.86 ◽

2020 ◽

Vol 3 (1) ◽

pp. 284-288

Author(s):

Dr. Priyanka Pawar ◽

Dr. Anil G Joshi

Keyword(s):

Deep Vein Thrombosis ◽

Comparative Study ◽

Lower Limb ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Colour Doppler ◽

Vein Thrombosis ◽

Deep Vein ◽

Limb Deep Vein Thrombosis

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Multiple systemic paradoxical embolisation of a lower limb deep vein thrombosis due to interatrial septal puncture: a rare complication of left atrial appendage occlusion

BMJ Case Reports ◽

10.1136/bcr-2021-244061 ◽

2021 ◽

Vol 14 (8) ◽

pp. e244061

Author(s):

Kevin Patrick Millar ◽

Rory Gallen ◽

Ihsan Ullah ◽

Samer Arnous

Keyword(s):

Deep Vein Thrombosis ◽

Lower Limb ◽

Left Atrial ◽

Left Atrial Appendage ◽

Atrial Appendage ◽

Left Middle Cerebral Artery ◽

Vein Thrombosis ◽

Left Atrial Appendage Occlusion ◽

Deep Vein ◽

Limb Deep Vein Thrombosis

A 75-year-old woman with a history of intracranial haemorrhage, atrial fibrillation and coronary artery bypass graft underwent elective left atrial appendage occlusion (LAAO) for stroke prevention. The procedure was successful, however on the third postoperative day, she presented with a lymph leak at the right femoral venous access site. She was admitted for conservative management of the lymph leak with immobility and intravenous fluids. Her inpatient stay was complicated by a right lower limb deep vein thrombosis (DVT), left middle cerebral artery territory ischaemic stroke, pulmonary emboli (PEs) and a splenic infarction. The mechanism of the systemic emboli was that of paradoxical emboli from the DVT passing through an interatrial septal defect created as part of the LAAO procedure, a previously unreported complication of LAAO. She was managed with 6 months of low-dose oral anticoagulation for treatment of DVT and PE and has made a full neurological recovery.

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