ABSTRACT
Study design: Retrospective cohort study.
Clinical question: What is the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) after
major spine surgery when no prophylactic measures were used?
Methods: A prospective evaluation of 121 patients who underwent 128 major spine surgeries
was conducted to determine the incidence of clinically identifiable DVT. As a matter
of practice, no patient was given thromboprophylaxis, either mechanical or chemical.
Results: Only one patient developed the signs and symptoms of DVT, which was further confirmed
by a Doppler study. The overall incidence of DVT was 0.78%. There was no clinically
evident case of PE.
Conclusions: Considering the low rate of incidence of DVT and PE, routine screening and prophylaxis
for DVT appears unwarranted in major spine surgery.
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Final class of evidence—prognosis
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Study design
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Prospective cohort
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Retrospective cohort
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Case control
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Case series
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Methods
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Patients at similar point in course of treatment
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F/U ≥ 85%
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Similarity of treatment protocols for patient groups
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Patients followed up long enough for outcomes to occur
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Control for extraneous risk factors
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Overall class of evidence
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III
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The definiton of the different classes of evidence is available here.
