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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

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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)

Submitter: 山田 勝久

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