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Rapidly progressive cervical myelopathy had a high risk of developing deep venous thrombosis : a prospective observational study in 289 cases with degenerative cervical spine disease
Title: | Rapidly progressive cervical myelopathy had a high risk of developing deep venous thrombosis : a prospective observational study in 289 cases with degenerative cervical spine disease |
Authors: | Yamada, Katsuhisa Browse this author | Suda, Kota Browse this author | Matsumoto Harmon, Satoko Browse this author | Komatsu, Miki Browse this author | Ushiku, Chikara Browse this author | Takahata, Masahiko Browse this author →KAKEN DB | Minami, Akio Browse this author →KAKEN DB | Iwasaki, Norimasa Browse this author →KAKEN DB |
Issue Date: | Jan-2019 |
Publisher: | Nature research |
Journal Title: | Spinal cord |
Volume: | 57 |
Issue: | 1 |
Start Page: | 58 |
End Page: | 64 |
Publisher DOI: | 10.1038/s41393-018-0213-9 |
Abstract: | Study design: A prospective observational study. Objectives: To determine the incidence of deep venous thrombosis (DVT) and to evaluate the risk factors for DVT development associated with degenerative cervical spine disease. Setting: Hokkaido Spinal Cord Injury Center, Japan. Methods: Between April 2008 and March 2015, patients with degenerative cervical spine disease, such as compressive myelopathy or radiculopathy, who underwent surgical treatment were prospectively assessed. Leg vein ultrasonography and D-dimer tests were performed preoperatively and at 4 days after surgery. All patients received treatment with intermittent pneumatic compression and elastic stockings for primary DVT prophylaxis. No anticoagulation medications were used for DVT prophylaxis. Results: A total of 289 patients (203 males, 86 females; median age: 67 years (interquartile range, 58-76)) were included. Nine patients (3.1%) exhibited DVT during the perioperative period. All 9 cases were women who had distal DVT. The incidences of preoperative and postoperative DVT were 1.1% and 2.1%, respectively. The univariate analysis showed that statistically significant risk factors for perioperative DVT included female gender (P < 0.01), advanced age (P = 0.04), a low Japanese Orthopaedic Association score (P = 0.03), rapidly progressive myelopathy (P < 0.01), and inability to walk (P = 0.01). The multivariate analysis showed that rapidly progressive myelopathy (P = 0.04) was the most important risk factor. Conclusion: Female gender and rapidly progressive myelopathy are high-risk factors that predict the development of DVT during the perioperative period of cervical spine surgery. This result indicates that screening and treatment for DVT are needed in such high-risk patients. |
Type: | article (author version) |
URI: | http://hdl.handle.net/2115/73804 |
Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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Submitter: 山田 勝久
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