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| Study of the Effect of Low Molecular Weiqht Heparin and Oral Anticoaqulant in Prevention Deep Venous Thrombosis and Pulmonary Embolism After Spinal Jnjury |
| ZHENG Zilei, ZHANG Yuping, LI Haiying, et al |
| The Second Hospital of Zhangjiakou, Hebei Zhangjiakou 075000, China |
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Abstract Objective: Patients with spinal trauma are at high risk of venous thromboembolism (VTE). To compare the effects of direct oral anticoagulants (DOACs) and low molecular weight heparin (LMWH) on the outcome of patients with surgical spinal injury. Methods: A total of 760 spinal trauma surgery patients treated in our hospital from 2015 to 2020 were included. According to the treatment conditions of patients, they were divided into DOACs group and LMWH group, and the intervention rate and mortality of deep venous thrombosis (DVT), pulmonary embolism (PE), red blood cell infusion rate (PRBC) and spinal decompression surgery were compared between the two groups. Results: A total of 760 patients were included, including 415 patients who received LWMH for postoperative thrombosis prevention and 345 patients who received DOACs for postoperative thrombosis prevention. The mean age of patients was (61.73±15) years, 59% were male, and the median injury level was 12(10~18). There were no differences between the two groups in demography, vital signs, injury parameters, length of hospital stay, ivC filter placement rate and time to start thrombus prophylaxis. The incidence of hospital DVT was 5.4%, the incidence of hospital PE was 1.3%, and the mortality was 2.8%. DOACs had a lower incidence of DVT(1.2% vs 8.9%, P<0.002) and pulmonary PE (0.3% vs 2.1%, P=0.24). There were no differences in mortality, postoperative pRBC transfusion rate, or overall incidence of postoperative spinal decompression. Conclusion: DOAC can effectively reduce the incidence of DVT and PE in patients with spinal trauma surgery. This study provides a solid basis for future studies.
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2021, Vol. 27 
