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Duplex ultrasound surveillance for deep vein thrombosis after acute traumatic spinal cord injury at rehabilitation admission.

Authors
  • Hon, Beverly1
  • Botticello, Amanda1, 2
  • Kirshblum, Steven1, 2, 3
  • 1 Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA. , (Jersey)
  • 2 Kessler Foundation Research Center, West Orange, New Jersey, USA. , (Jersey)
  • 3 Kessler Institute for Rehabilitation, West Orange, New Jersey, USA. , (Jersey)
Type
Published Article
Journal
The journal of spinal cord medicine
Publication Date
May 01, 2020
Volume
43
Issue
3
Pages
298–305
Identifiers
DOI: 10.1080/10790268.2019.1585134
PMID: 30939080
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Context/objective: To determine the prevalence of deep vein thrombosis (DVT) detected through routine duplex screening and factors associated with DVT in spinal cord injury (SCI) patients on admission to rehabilitation.Design: Retrospective chart review of medical records.Setting: Acute inpatient rehabilitation.Participants: One hundred and eighty-nine individuals admitted to rehabilitation within 2 weeks of initial traumatic SCI who underwent routine surveillance with duplex scan for DVT.Interventions: Duplex scan of lower extremities.Outcome measures: The dependent variable was positive duplex screening for either any DVT (distal and/or proximal) or proximal DVT.Results: Of the 189 patients, 31 patients (16.4%) had a positive scan for any (proximal and/or distal) DVT, with 9 (4.8%) positive for a proximal DVT and 22 (11.6%) positive for isolated distal DVT. Of those with isolated distal DVT, 31.8% later developed propagation with either proximal DVTs or pulmonary embolism (mean = 22 days). Factors significantly associated with positive duplex scans for any (proximal and/or distal) DVT include more severe neurological injury (AIS A, B or C versus AIS D: χ2 = 7.1791, df = 1, P = 0.007) and older age (age ≥50 years old: χ2 = 14.9410, df = 1, P = 0.000).Conclusion: In acute traumatic SCI, older age and more severe neurological impairment (AIS A, B, and C) are independent risk factors for positive duplex screening for any (proximal and/or distal) DVT detected on rehabilitation admission. Individuals with an acute distal DVT have a high likelihood for future thrombus progression. Routine surveillance for these patients may be warranted.

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