TY - JOUR
T1 - Venous thromboembolism after spinal cord injury
T2 - Incidence, time course, and associated risk factors in 16,240 adults and children
AU - Jones, Tracey
AU - Ugalde, Viviane
AU - Franks, Peter
AU - Zhou, Hong
AU - White, Richard H
PY - 2005/12
Y1 - 2005/12
N2 - Objective: To analyze the incidence of venous thromboembolism (VTE) after spinal cord injury (SCI). Design: Retrospective cohort analysis of all SCI cases (16,240) in California from 1991 through 2001. Setting: All public hospitals in California. Participants: Subjects (cases) coded as having complete or incomplete SCI. Interventions: Not applicable. Main Outcome Measure: Diagnosis of VTE or death within 91 days of the day of hospital admission. Results: For all cases, the 91-day cumulative incidence of VTE was 5.4%. In a multivariate model, significant predictors of VTE included male sex (odds ratio [OR]=1.4; 95% confidence interval [CI], 1.2-1.7), African-American race (OR=1.6; 95% CI, 1.3-1.9), complete paraplegia versus tetraplegia (OR=1.8; 95% CI, 1.4-2.3), and presence of 3 or more comorbid conditions versus none (OR=1.6; 95% CI, 1.3-2.1). Age less than 14 years was predictive of not developing VTE (OR=0.2; 95% CI, 0.1-0.7). The incidence of VTE did not change significantly over the 11-year time period (P=.07), and VTE was not a significant predictor of death in the first 91 days after hospitalization. Conclusions: The incidence of VTE in SCI patients in California did not change between 1991 and 2001. We identified specific risk factors for VTE. Further studies are needed to determine if prompt initiation of medical prophylaxis in high risk subjects reduces the incidence of symptomatic VTE.
AB - Objective: To analyze the incidence of venous thromboembolism (VTE) after spinal cord injury (SCI). Design: Retrospective cohort analysis of all SCI cases (16,240) in California from 1991 through 2001. Setting: All public hospitals in California. Participants: Subjects (cases) coded as having complete or incomplete SCI. Interventions: Not applicable. Main Outcome Measure: Diagnosis of VTE or death within 91 days of the day of hospital admission. Results: For all cases, the 91-day cumulative incidence of VTE was 5.4%. In a multivariate model, significant predictors of VTE included male sex (odds ratio [OR]=1.4; 95% confidence interval [CI], 1.2-1.7), African-American race (OR=1.6; 95% CI, 1.3-1.9), complete paraplegia versus tetraplegia (OR=1.8; 95% CI, 1.4-2.3), and presence of 3 or more comorbid conditions versus none (OR=1.6; 95% CI, 1.3-2.1). Age less than 14 years was predictive of not developing VTE (OR=0.2; 95% CI, 0.1-0.7). The incidence of VTE did not change significantly over the 11-year time period (P=.07), and VTE was not a significant predictor of death in the first 91 days after hospitalization. Conclusions: The incidence of VTE in SCI patients in California did not change between 1991 and 2001. We identified specific risk factors for VTE. Further studies are needed to determine if prompt initiation of medical prophylaxis in high risk subjects reduces the incidence of symptomatic VTE.
KW - Pulmonary embolism
KW - Rehabilitation
KW - Spinal cord injuries
KW - Thromboembolism
KW - Venous thrombosis
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U2 - 10.1016/j.apmr.2005.07.286
DO - 10.1016/j.apmr.2005.07.286
M3 - Article
C2 - 16344018
AN - SCOPUS:28844457996
VL - 86
SP - 2240
EP - 2247
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 12
ER -