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Título

COMPARISON OF CHEMOPROPHYLAXIS AND NONCHEMOPROPHYLAXIS FOR DEEP VEIN THROMBOSIS IN ELECTIVE SPINE SURGERY: SYSTEMATIC REVIEW AND META-ANALYSIS

Introdução

To compare chemoprophylaxis and nonchemoprophylaxis in elective spine surgery in order to determine risks of DVT, PTE and epidural hematoma (EH) in both groups, as well as their respective treatment efficacy.

Relato de caso

Systematic review and meta-analysis based on systematically searched articles, using combinations of MESH terms related to chemoprophylaxis and nonchemoprophylaxis for prevention of deep vein thrombosis and pulmonary embolism in elective spine surgery. Adult patients were eligible for inclusion in the study, except those with trauma, spinal cord injury, neoplasms and those using vena cava filters. Results: Five studies were included in the final analysis to form part of this systematic review and meta-analysis being 3 retrospective studies, 1 prospective study and 1 case series. Data analysis showed that 4.64% of patients treated with chemoprophylaxis had an unfavorable outcome regarding DVT, while this outcome occurred in 1.14% of patients not treated with chemoprophylaxis (p=0,001). Among patients using chemoprophylaxis, only 0.1% developed epidural hematoma and 0.38% developed PTE. Among those on non-drug prophylaxis, 0.04% had EH (p=0,11) and 0.42% had PTE (p=0,45).

Conclusão

No benefits were found for chemoprophylaxis when compared to nonchemoprophylaxis for preventing DVT in elective spine surgery, nor did it increase the risk of epidural hematoma or fatal thromboembolic events.

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