Anatomic distribution and analysis of influencing factors on deep vein thrombosis in patients with spinal fractures caused by high-energy injuries.

Abstract

Purpose: To analyze the anatomic distribution and influencing factors on deep vein thrombosis (DVT) in patients with spinal fractures caused by high-energy injuries.

Methods: A retrospective analysis was performed on 302 patients of lower extremity DVT who were admitted to our hospital from January 2018 to December 2023. All patients underwent ultrasonography of DVT before and after surgery. The thrombus location and clinical data of thrombus were recorded in detail. Logistic regression was used to analyze the influencing factors on thrombus distribution.

Results: There were 27 cases of central DVT and 261 cases of peripheral DVT before surgery, 90 cases of central DVT and 212 cases of peripheral DVT after surgery. There were statistically significant differences in the types of thrombus during perioperative period among patients with cervical, thoracic, and lumbar fractures. After surgery, there were 120 cases of thrombus progression, 33 cases of thrombus regression, and 149 cases of thrombus without change. The intermuscular veins account for 75.57%. The time from injury to surgery and D-dimer at admission were influencing factors for preoperative DVT distribution while blood loss, time from injury to surgery and post 3-D-dimer were influencing factors for postoperative DVT distribution.

Conclusions: The proportion of postoperative thrombus progression was relatively high, with only a small portion experiencing thrombolysis. Patients with cervical fractures were more prone to central DVT. The intermuscular vein was the most common vein for thrombosis. The time from injury to surgery, D-dimer at admission, blood loss and post 3-D-dimer were influencing factors for DVT distribution.