Thrombotic Event Prevention in Patients Undergoing Posterior Lumbar Arthrodesis: our experiencie. A retrospective case series study. / Prevención de eventos trombóticos en pacientes sometidos a cirugía de artrodesis lumbar por vía posterior: experiencia en nuestro centro. Estudio retrospectivo de casos.

INTRODUCTION: There is no generalized consensus regarding perioperative prophylaxis of venous thromboembolism (VTE), either on using or timing it in patients undergoing spine surgery. VTE is a current concern because, even though being an uncommon event, it can cause serious complications. The aim of the present study is to propose guidelines for the prevention of thrombotic events in posterior spinal surgery, either as deep vein thrombosis or pulmonary thromboembolism. If the number of patients getting prophylaxis drugs is reduced a subsequent reduction of the incidence of epidural hematoma can be expected. MATERIALS AND METHODS: A number of 235 patients who had undergone posterior spinal arthrodesis in the previous five years were studied. Mechanical thromboprophylaxis measures consisting of compression stockings were applied in all of them. Anticoagulant drugs were also applied whenever risk factors for thrombosis were observed. Early weight-bearing was resumed immediately after surgery. Demographic, clinical, and surgical variables were collected, as well as complications appearing during the follow-up period, that was scheduled at one, two, four, six and twelve months after the surgery. Thrombotic events, if present, were diagnosed by clinical and imaging tests such as ultrasound and CT angiography. RESULTS: From the total 235 patients of this series, one hundred and fifty-three cases met the study inclusion criteria. A total of four thrombotic events appeared, one in the form of deep vein thrombosis and other three in the form of pulmonary thromboembolism. These last patients suffering an embolism died because of it. None of the variables studied had statistical significance for the occurrence of a thrombotic event. All four patients who suffered thrombotic events were receiving anticoagulant drugs, in addition to mechanical compression stockings, because of the presence of risk factors for thrombosis. CONCLUSIONS: By applying the fore mentioned protocol, adequate prevention of thromboembolic events was achieved in this study population of patients undergoing posterior spinal surgery.

[The health situation of the non-institutionalized elderly urban population of Castro Uridiales and the differentiating characteristics of those attending the health center frequently]. / Situación sanitaria de la población anciana urbana no institucionalizada de Castro Urdiales, y características diferenciadoras de los que más frecuentan el centro de salud.

OBJECTIVES: Main: to describe the health situation of the urban non-institutionalised population of 75 or over in Castro Urdiales. Secondary. To analyse the differences in the over-user group. DESIGN: Descriptive, crossover. SETTING: Primary Care Health Centre. PATIENTS: People in the urban area aged 75 or over and with the following inclusion criteria: not institutionalised, who had been at least 6 months in the town, and for whom there was data for locating them. Over-users: people in the upper third of attendance (9 or more consultations per year). MEASUREMENTS AND MAIN RESULTS: A "Comprehensive Geriatric Assessment" was performed, cognitive state (Pfeiffer) and social assessment. The over-user group functioned better, had a better cognitive state and consumed more medication. CONCLUSIONS: The results coincided with other studies in most of the items analysed. It is important to be aware of the worse functional and cognitive condition of the group which attended the Health Centre least. Sub-groups of the elderly still need to be studied.