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  4. Deep venous thrombosis in patients with chronic spinal cord injury

Deep venous thrombosis in patients with chronic spinal cord injury

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1179/2045772315Y.0000000032 · Published: January 1, 2016

Spinal Cord InjuryCardiovascular ScienceRehabilitation

Simple Explanation

Deep venous thrombosis (DVT) is a serious complication after spinal cord injury (SCI), where blood clots form in the deep veins, usually in the legs. While it's known to be a risk soon after the injury, this study looks at how common DVT is in people with long-term SCI. The study found that DVT can still occur in patients with chronic SCI, especially within the first six months after the injury. This suggests that the risk of blood clots remains elevated for a longer period than just the initial few months after the injury. The researchers used ultrasound to check for DVT in patients who were more than three months post-SCI. They also looked at factors like age, injury severity, and whether the patients were taking blood thinners to see if these factors were related to DVT.

Study Duration
2007-2009 and 2011-2013
Participants
63 patients with SCI
Evidence Level
Cross-sectional study

Key Findings

  • 1
    DVT was diagnosed in 5 of the 63 patients with chronic SCI.
  • 2
    Four of the five DVT cases occurred within the first 4-5 months post-injury, while one case occurred 42 months post-injury.
  • 3
    Despite some patients receiving prolonged prophylaxis with low molecular weight heparin (LMWH), DVT was still diagnosed in some cases.

Research Summary

This cross-sectional study examined the prevalence of DVT in 63 patients with chronic SCI (more than 3 months post-injury). DVT was detected using venous duplex scans. The study found a DVT prevalence of 8% in the studied population. Most cases were detected within the first six months post-injury, indicating a continued risk of DVT in the chronic phase of SCI. The authors suggest that prolonged thromboprophylaxis might be considered for patients with SCI up to 6 months post-injury, especially given the potential for asymptomatic presentation of DVT and the limitations of current diagnostic methods.

Practical Implications

Extended Thromboprophylaxis

Consider extending DVT prophylaxis up to 6 months post-SCI, especially for high-risk individuals.

Vigilant Monitoring

Maintain vigilance for DVT symptoms in chronic SCI patients, even beyond the acute phase.

Further Research

Conduct further research to identify specific risk factors and optimal prophylaxis strategies for DVT in chronic SCI.

Study Limitations

  • 1
    Small sample size, limiting statistical power.
  • 2
    Admission of patients at disparate times to the rehabilitation department.
  • 3
    Single-center study, potentially limiting generalizability.

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