ORIGINAL
Introdução: a verdadeira incidência de Tromboembolia Venosa Profunda (TVP) relacionada com cirurgia da coluna e o perfil da população em risco permanecem temas debatidos, variando entre 0,3% e 31% na literatura. Objetivo: este estudo tem como objetivo avaliar a incidência e estudar os fatores de risco relacionados com a ocorrência de TVP após cirurgia da coluna e estimar o impacto da tromboprofilaxia no desenvolvimento de TVP. Métodos: analisamos retrospectivamente todos os pacientes submetidos a cirurgia da coluna num centro de cirurgia de coluna entre 2015 e 2019, com pelo menos doze meses de acompanhamento. Resultados: foi incluído um total de 1280 pacientes. Dezassete pacientes (1,3%) desenvolveram um evento de TVP no período de acompanhamento. O tempo mediano até o evento foi de 28 dias, com 50% dos eventos de TVP ocorrerendo no primeiro mês. A idade média na altura da cirurgia foi de cinquenta e sete anos. A cirurgia oncológica da coluna (n=2; 11,8%) e os procedimentos que envolveram abordagem anterior e posterior (n=5; 29,4%) revelaram taxas significativamente mais elevadas de TVP (p < 0,05). Entre os eventos tromboembólicos, oito (47,1%) pacientes utilizaram pelo menos um método de tromboprofilaxia. A quimioprofilaxia para TVP não foi associada a uma menor ocorrência de TVP (p= 0,184) e o uso intravenoso de ácido tranexâmico não foi considerado um fator de risco para TVP (p= 0,176). Conclusão: a incidência de TVP após cirurgia da coluna é baixa. A tromboprofilaxia não foi um preditor independente significativo de eventos tromboembólicos no nosso estudo. Idade, sexo e uso intravenoso de ácido tranexâmico não influenciaram a incidência de TVP. São necessários mais estudos com um maior número de pacientes para abordar a relação risco-benefício da tromboprofilaxia.
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1Orthopedic Surgery and Traumatology Department, Hospital de Braga, Braga, Portugal.
2Life and Health Sciences Research Institute – ICVS, School of Medicine, University of Minho, Braga, Portugal.
Received June 23, 2022
Accepted July 28, 2024