Risk Factors Of Lower Extremity Venous Thrombosis After Spinal Metastasis Surgery

Objective:To investigate the risk factors related to postoperative venous thrombosis of lower limbs in patients with spinal metastasis,and to provide reference for preoperative correction of modifiable risk factors,thus reducing the incidence of postoperative venous thrombosis of lower limbs.Methods:A retrospective study was conducted on 182 patients with spinal metastases who underwent surgical treatment in the Spinal Surgery Department of Xiangya Hospital of Central South University and the Second Xiangya Hospital of Central South University from January 2016 to January 2022.All the enrolled patients were diagnosed with spinal metastasis of malignant tumor by preoperative pathological biopsy or postoperative pathological examination,and underwent surgical treatment.The basic information of patients was collected: gender,age and blood type;Preoperative factors: history of hypertension,history of diabetes,history of smoking,triglyceride value,cholesterol value,fibrin value,D-dimer value,hematocrit,white blood cell count,platelet count;Intraoperative factors: operative time,intraoperative blood loss,intraoperative red blood cell volume;Postoperative factors:postoperative anticoagulation,postoperative bed time,and record the results of postoperative color ultrasound examination of lower limbs.According to the corresponding standards for statistical analysis,calculate the incidence of lower limb thrombosis,and get the risk factors related to it.Statistical methods:Computer software SPSS26.0 was used for statistical data analysis,T-test was used for quantitative data,and the Chi-square test was used for qualitative data.Logistic regression analysis was conducted for statistically significant correlation factors in test results,and p < 0.05 was considered statistically significant.Drawing method:All patients were divided into the Thrombus group and the non-thrombus group.Graph-Pad Prism9.3 was used to input the grouped data and make histogram and dot graph.Result:1.T-test or Chi-square test:Age ≥60 years(p =0.007),triglyceride value(p=0.017),cholesterol value(p=0.047),fibrin original value(p=0.003),D-dimer value(p=0.006),operation time(p=0.015),intraoperative blood loss(p=0.043),intraoperative red blood cell volume(p<0.01),postoperative bed time(p<0.01),postoperative anti-coagulation(p=0.021),history of hypertension(p<0.01),history of diabetes(p=0.006),smoking(p=0.003),there were statistically significant differences in the above influencing factors(p<0.05).Gender(p=0.074),blood type(p=0.562),HCT(p=0.472),white blood cell count(p=0.174),platelet count(p =0.342),there were no significant differences in the above influencing factors(p > 0.05).2.2.Logistic regression analysis:Age ≥60 years(p=0.021),triglyceride value(p=0.034),cholesterol value(p=0.032),fibrin value(p=0.019),intraoperative red blood cell volume(p=0.019),postoperative bed time(p=0.001),history of hypertension(p=0.045),smoking(p=0.020),There was statistical significance in the above factors(p <0.05).D-dimer value(p =0.315),operation time(p=0.325),intraoperative blood loss(p=0.183)and diabetes history(p=0.833)there were no significant differences in the above influencing factors(p > 0.05).Conclusion:1.Age ≥60 years,triglyceride,cholesterol values,the original value of the fibrin,D-dimer value,operation time,intraoperative blood loss,intraoperative transfusion of red blood cell volume,postoperative bed time,postoperative anti-coagulation status,history of hypertension,diabetes,and smoking status and lower limb venous thrombosis related to postoperative mortality in patients with spinal metastases.2.Age ≥60 years,triglyceride value,cholesterol value,fibrin value,intraoperative red blood cell volume,postoperative bed time,postoperative anticoagulant status,history of hypertension and smoking status were independent risk factors for postoperative lower extremity venous thrombosis in patients with spinal metastatic tumor.