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  4. Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature

Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature

Asian Spine J, 2016 · DOI: 10.4184/asj.2016.10.5.972 · Published: October 1, 2016

Spinal Cord InjuryCardiovascular ScienceResearch Methodology & Design

Simple Explanation

This study reviews the risk of blood clots in the lungs (pulmonary embolism) and deep veins (deep vein thrombosis) in people with spinal cord injuries during the sub-acute phase, which is 3–6 months after the injury. The authors looked at previous studies to find out how common these blood clots are during this time and what kind of treatments are used to prevent them. The review found that spinal cord injury patients continue to have a significant risk of blood clots even after the initial injury period. Doctors should therefore be vigilant about the possibility of blood clots and consider continuing preventative treatments for a longer time.

Study Duration
Not specified
Participants
Seven articles were included in the review
Evidence Level
Systematic Review

Key Findings

  • 1
    The review identified seven relevant articles, but they were too different to combine their results statistically.
  • 2
    The included studies reported that the incidence of pulmonary embolism (PE) ranged from 0.5% to 6.0%, while the incidence of deep vein thrombosis (DVT) ranged from 2.0% to 8.0% in the sub-acute phase of SCI.
  • 3
    The type of thromboprophylaxis used was poorly reported in the studies.

Research Summary

This systematic review aimed to assess the evidence regarding the incidence of thromboembolism and the use of prophylaxis in the sub-acute phase (3–6 months post-injury) of spinal cord injury (SCI). The review included seven articles, which were mostly retrospective case series or cohort studies. The studies reported a PE incidence of 0.5%–6.0% and a DVT incidence of 2.0%–8.0% in the sub-acute phase of SCI. The review concludes that spinal patients continue to have a significant risk of PE and DVT after the acute period of their injury and that clinicians should maintain a high level of suspicion for venous thromboembolism in the sub-acute phase, potentially extending prophylactic anticoagulation therapy.

Practical Implications

Prolonged Thromboprophylaxis

Consider extending thromboprophylaxis beyond the standard 3 months in SCI patients.

Increased Clinical Vigilance

Maintain a low threshold for suspecting VTE in SCI patients during the sub-acute phase.

Further Research Needed

Conduct larger, well-documented prospective cohort studies to determine precise VTE incidence rates.

Study Limitations

  • 1
    Retrospective study designs limit the quality of evidence.
  • 2
    Heterogeneity between studies prevented meta-analysis.
  • 3
    Poor reporting of thromboprophylaxis made it difficult to assess its impact.

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