Document Type
Article
Publication Date
9-10-2020
Abstract
STUDY DESIGN: Cross-sectional, international survey.
OBJECTIVES: To identify factors influencing pharmacologic anticoagulation initiation after spine surgery based on the AOSpine Anticoagulation Global Survey.
METHODS: This survey was distributed to the international membership of AOSpine (n = 3805). A Likert-type scale described grade practice-specific factors on a scale from low (1) to high (5) importance, and patient-specific factors a scale from low (0) to high (3) importance. Analysis was performed to determine which factors were significant in the decision making surrounding the initiation of pharmacologic anticoagulation.
RESULTS: A total of 316 spine surgeons from 64 countries completed the survey. In terms of practice-specific factors considered to initiate treatment, expert opinion was graded the highest (mean grade ± SD = 3.2 ± 1.3), followed by fellowship training (3.2 ± 1.3). Conversely, previous studies (2.7 ± 1.2) and unspecified guidelines were considered least important (2.6 ± 1.6). Patient body mass index (2.0 ± 1.0) and postoperative mobilization (2.3 ± 1.0) were deemed most important and graded highly overall. Those who rated estimated blood loss with greater importance in anticoagulation initiation decision making were more likely to administer thromboprophylaxis at later times (hazard ratio [HR] = 0.68-0.71), while those who rated drain output with greater importance were likely to administer thromboprophylaxis at earlier times (HR = 1.32-1.43).
CONCLUSION: Among our global cohort of spine surgeons, certain patient factors (ie, patient mobilization and body mass index) and practice-specific factors (ie, expert opinion and fellowship training) were considered to be most important when considering anticoagulation start times.
Recommended Citation
Gandhi, Sapan D; Khanna, Krishn; Harada, Garrett; Louie, Philip; Harrop, James; Mroz, Thomas; Al-Saleh, Khalid; Brodano, Giovanni Barbanti; Chapman, Jens; Fehlings, Michael G; Hu, Serena S; Kawaguchi, Yoshiharu; Mayer, Michael; Menon, Venugopal; Park, Jong-Beom; Rajasekaran, Shanmuganathan; Valacco, Marcelo; Vialle, Luiz; Wang, Jeffrey C; Wiechert, Karsten; Riew, K Daniel; and Samartzis, Dino, "Factors Affecting the Decision to Initiate Anticoagulation After Spine Surgery: Findings From the AOSpine Anticoagulation Global Initiative" (2020). Department of Neurosurgery Faculty Papers. Paper 127.
https://jdc.jefferson.edu/neurosurgeryfp/127
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
32911980
Language
English
Comments
This is the final published version of the article in the Global Spine Journal, 2020 Sep
The published version can also be accessed at https://doi.org/10.1177/2192568220948027.
Copyright. The Authors.