Association of venous thromboembolism following pediatric traumatic spinal injuries with injury severity and longer hospital stays

作者：Blake M. Hauser, Samantha E. Hoffman, Saksham Gupta, Mark M. Zaki, Edward Xu, Melissa Chua, Joshua D. Bernstock, Ayaz Khawaja, Timothy R. Smith, Mark R. Proctor, Hasan A. Zaidi · 发表于：Journal of Neurosurgery Spine · 年份：2021 · DOI：10.3171/2021.3.spine201981 · 被引用次数：11 · 研究领域：Venous Thromboembolism Diagnosis and Management、Blood Coagulation and Thrombosis Mechanisms、Spinal Cord Injury Research

OBJECTIVE: Venous thromboembolism (VTE) can cause significant morbidity and mortality in hospitalized patients, and may disproportionately occur in patients with limited mobility following spinal trauma. The authors aimed to characterize the epidemiology and clinical predictors of VTE in pediatric patients following traumatic spinal injuries (TSIs). METHODS: The authors conducted a retrospective cohort analysis of children who experienced TSI, including spinal fractures and spinal cord injuries, encoded within the National Trauma Data Bank from 2011 to 2014. RESULTS: Of the 22,752 pediatric patients with TSI, 192 (0.8%) experienced VTE during initial hospitalization. Proportionally, more patients in the VTE group (77%) than in the non-VTE group (68%) presented following a motor vehicle accident. Patients developing VTE had greater odds of presenting with moderate (adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI] 1.4-4.8) or severe Glasgow Coma Scale scores (aOR 4.3, 95% CI 3.0-6.1), epidural hematoma (aOR 2.8, 95% CI 1.4-5.7), and concomitant abdominal (aOR 2.4, 95% CI 1.8-3.3) and/or lower extremity (aOR 1.5, 95% CI 1.1-2.0) injuries. They also had greater odds of being obese (aOR 2.9, 95% CI 1.6-5.5). Neither cervical, thoracic, nor lumbar spine injuries were significantly associated with VTE. However, involvement of more than one spinal level was predictive of VTE (aOR 1.3, 95% CI 1.0-1.7). Spinal cord injury at any level was also significantly associated with d...