Adolescent Spinal Fusion: 5 Findings on VTE Complication

Written by Laura Dyrda | July 14, 2014 | Print  |

A group of spine surgeon researchers examined trends for thromboembolic complications in children who underwent spinal fusion and published their results in Spine.

The data was gathered from the Nationwide Inpatient Sample database from 2001 to 2010 and includes children 18 years old or younger. Here are five findings from the study:

 

1. VTE incidence among children varied from 9.6 to 38.4 events per 10,000 spinal fusions depending on the year. The average over the nine-year period was 21 events per 10,000 spinal fusions. A study published in the Journal of Bone and Joint Surgery found older patients in their 50s were more likely than younger patients to develop VTE after spinal fusion, and men were more likely than women to develop VTE. Additional factors associated with VTE included:

 

•    White race
•    Longer hospital stays
•    Comorbidities
•    Multiple procedures done during hospitalization

 

2. The incidence of PE varied from zero to six events per 10,000 spinal fusions. The average was two events per 10,000 spinal fusions.

 

3. Only the patient diagnosis was significantly associated with VTE development, according to a multivariate logistic regression analysis of the data. Children with congenital scoliosis, syndromic scoliosis/kyphoscoliosis and thoracolumbar fractures experienced a higher rate of VTE than children with idiopathic scoliosis. The odds of developing VTE were:

 

•    Congenital scoliosis: 4.21
•    Syndromic scoliosis/kyphoscolioisis: 7.14
•    Thoracolumbar fractures: 12.59

 

4. Age was a significant factor in VTE development according to a univariate analysis. The VTE incidence increased 1.37-fold every year. The JBJS article also found total hospital charges were much higher for patients with VTE. Total hospital charges were $66,823 for patients without VTE; charges were $207,253 for patients with VTE.

 

5. There were no in-hospital VTE-associated mortalities. PE was also rare and was not associated with any fatality. However, a study published earlier this year in Spine found several VTE cases were discovered after discharged and 40 percent of those cases were diagnosed at a different hospital. In this case, the primary physician may be unaware of the complication. In-hospital mortality rates also increased 15-fold when DVT was present, according to the report.

 

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