[Factor analysis and tempral distribution of postoperative lower limb deep venous thrombosis in patients with cervical spine fracture and paraplegia].

Authors

Jin Wang, Xiaoxia Kang, Wenli Zhu

Published in

Zhongguo gu shang = China journal of orthopaedics and traumatology. Volume 39. Issue 7. Pages 670-6. Jul 25, 2026.

Abstract

To investigate the risk factors and tempral distribution of lower extremity deep vein thrombosis(DVT) formation after surgery in patients with cervical spine fracture and paraplegia.
A total of 98 patients with cervical fracture and paraplegia admitted between January 2020 and January 2023 were enrolled in this study, including 50 males and 48 females. The age ranged from 18 to 80 years with a mean of (63.39±7.26) years, and the body mass index (BMI) ranged from 22.35 to 28.17 with a mean of (24.64±1.71) kg·m^-2. Patients were divided into a DVT group (n=22) and a non-DVT group (n=76) based on the occurrence of postoperative DVT. General clinical data were compared between the two groups. The tempral distribution of DVT occurrence was analyzed in DVT patients at preoperation and on postoperative days 1,3,7, and 14, along with management strategies for different types of thrombus formation. Logistic regression analysis was performed to identify independent risk factors associated with postoperative DVT in patients with cervical fracture and paraplegia. A nomogram model was then constructed based on these identified independent predictors to estimate the risk of postoperative DVT in this patient population.
Among the 98 patients who underwent surgical treatment for cervical fractures, 22 developed DVT, yielding an incidence rate of 22.45% (22/98). The peak onset of DVT occurred on the first postoperative day. The number of DVT cases detected preoperatively and on postoperative days 1,3,7, and 14 were 0,16,1,1, and 4, respectively. BMI≥25 kg·m^-2, comorbid hypertension, elevated hemoglobin levels, high hematocrit, and the presence of large vascular atherosclerotic plaques were identified as independent risk factors for postoperative DVT in patients with cervical fracture and paraplegia (P<0.05). A nomogram model was constructed based on these indicators. Internal validation using Bootstrap resampling (1 000 replications) demonstrated that the model yielded an area under the curve (AUC) of 0.928, 95%CI(0.829, 0.990), with a specificity of 0.942 and a sensitivity of 0.872 for predicting postoperative DVT.
Postoperative day 1 is the peak time for DVT occurrence. It is recommended that thromboprophylaxis measures be implemented as early as during or immediately after surgery. BMI, hypertension, hemoglobin, hematocrit, and atherosclerotic plaques in major vessels are independent risk factors for postoperative DVT. The nomogram constructed based on these factors can effectively predict the occurrence of postoperative DVT in patients with cervical spine fractures and paraplegia.

PMID:
42544802
Bibliographic data and abstract were imported from PubMed on 03 Aug 2026.

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