Venous thromboembolism and anticoagulation in spinal cord lesion rehabilitation inpatients: A 10-year retrospective study.
NeuroRehabilitation
; 53(1): 143-153, 2023.
Article
en En
| MEDLINE
| ID: mdl-37424485
ABSTRACT
BACKGROUND:
Venous thromboembolism (VTE) is a concern following the onset of spinal cord lesions (SCL).OBJECTIVES:
To assess the current efficacy and risks of anticoagulation after SCL and consider changes in thromboprophylaxis.METHODS:
This retrospective cohort study included individuals admitted to inpatient rehabilitation within 3 months of SCL onset. Main outcome measures were the incidence of deep vein thrombosis (DVT), pulmonary embolism (PE), bleeding, thrombocytopenia, or death, which occurred within 1 year of the SCL onset.RESULTS:
VTE occurred in 37 of the 685 patients included in the study (5.4%, 95% CI 3.7-7.1%, 2.8% PE), and in 16 of 526 patients who received prophylactic anticoagulation at rehabilitation (3%, 95% CI 1.6-4.5%, 1.1% PE, with at least 1 fatality). Of these 526, 1.3% developed clinically significant bleeding and 0.8% thrombocytopenia. Prophylactic anticoagulation, most commonly 40âmg/day, continued until a median period of 6.4 weeks after SCL onset (25% -75% percentiles 5.8-9.7), but in 29.7%, VTE occurred more than 3 months after SCL onset.CONCLUSION:
The VTE prophylaxis used for the present cohort contributed to a considerable but limited reduction of VTE incidence. The authors recommend conducting a prospective study to assess the efficacy and safety of an updated preventive anticoagulation regimen.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Embolia Pulmonar
/
Trombocitopenia
/
Tromboembolia Venosa
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
NeuroRehabilitation
Asunto de la revista:
NEUROLOGIA
/
REABILITACAO
Año:
2023
Tipo del documento:
Article
País de afiliación:
Israel