Patients often do not report symptoms due to the nature of their nerve damage. Initial VTE presentation may include extensive
thrombosisVenous thromboembolism after spinal cord injury
Robert W Teasell 1, Jane T Hsieh, Jo-Anne L Aubut, Janice J Eng, Andrei Krassioukov, Linh Tu, Spinal Cord Injury Rehabilitation Evidence Review Research Team
PMID: 19236977. PMCID: PMC3104991. DOI: 10.1016/j.apmr.2008.09.557
Abstract
Objective: To review systematically the published literature on the treatment of deep venous thromboembolism after spinal cord injury (SCI).
Data sources: MEDLINE/PubMed, CINAHL, EMBASE, and PsycINFO databases were searched for articles addressing the treatment of deep venous thromboembolism post-SCI. Randomized controlled trials (RCTs) were assessed for methodologic quality using the Physiotherapy Evidence Database Scale, while non-RCTs were assessed using the Downs and Black evaluation tool.
Study selection: Studies included RCTs, non-RCTS, cohort, case-control, case series, pre-post, and postinterventional studies. Case studies were included only when no other studies were available.
Data extraction: Data extracted included demographics, the nature of the study intervention, and study results.
Data synthesis: Levels of evidence were assigned to the interventions using a modified Sackett scale.
Conclusions: Twenty-three studies met inclusion criteria. Thirteen studies examined various pharmacologic interventions for the treatment or prevention of deep venous thrombosis in patients with SCI. There was strong evidence to support the use of low-molecular-weight heparin in reducing venous thrombosis events, and a higher adjusted dose of unfractionated heparin was found to be more effective than 5000 units administered every 12 hours, although bleeding complications were more common. Nonpharmacologic treatments were also reviewed, but again limited evidence was found to support these treatments.
Reference:
Arch Phys Med Rehabil. 2009 Feb;90(2):232-45. doi: 10.1016/j.apmr.2008.09.557.
Prevention of Venous Thromboembolism in Individuals with Spinal Cord Injury: Clinical Practice Guidelines for Health Care Providers, 3rd ed.: Consortium for Spinal Cord Medicine
No authors listed
PMID: 29339863. PMCID: PMC4981016. DOI: 10.1310/sci2203-209
See full article for guidelines.
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981016/
Reference:
Top Spinal Cord Inj Rehabil. Summer 2016;22(3):209-240. doi: 10.1310/sci2203-209.