Safety and effectiveness of early chemical deep venous thrombosis prophylaxis after spinal cord injury: pilot prospective data
| Autor: | Praveen V. Mummaneni, Anthony M DiGiorgio, Adam R. Ferguson, Geoffrey T. Manley, Sanjay S. Dhall, Michael S. Beattie, Mohanad Alazzeh, Jacqueline C. Bresnahan, Jenny Haefeli, Jason F. Talbott, William D. Whetstone, Rachel E. Tsolinas |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Low molecular weight heparin Pilot Projects Neurosurgical Procedures Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans Prospective Studies 030212 general & internal medicine Spinal cord injury Spinal Cord Injuries Venous Thrombosis business.industry Anticoagulants General Medicine Heparin Heparin Low-Molecular-Weight Middle Aged medicine.disease Surgery Pulmonary embolism Neurosurgical Procedure Venous thrombosis Cohort Female Observational study Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Neurosurgical Focus. 43:E21 |
| ISSN: | 1092-0684 |
| DOI: | 10.3171/2017.8.focus17437 |
| Popis: | OBJECTIVESpinal cord injuries (SCIs) occur in approximately 17,000 people in the US each year. The average length of hospital stay is 11 days, and deep venous thrombosis (DVT) rates as high as 65% are reported in these patients. There is no consensus on the appropriate timing of chemical DVT prophylaxis for this critically injured patient cohort. The object of this study was to determine if low-molecular-weight heparin (LMWH) was safe and effective if given within 24 hours of SCI.METHODSThe Transforming Research and Clinical Knowledge in SCIs study is a prospective observational study conducted by the UCSF Brain and Spinal Injury Center. Protocol at this center includes administration of LMWH within 24 hours of SCI. Data were retrospectively reviewed to determine DVT rate, pulmonary embolism (PE) rate, and hemorrhagic complications.RESULTSForty-nine patients were enrolled in the study. There were 3 DVTs (6.1%), 2 PEs (4.1%), and no hemorrhagic complications. Regression modeling did not find an association between DVT and/or PE and age, American Spinal Injury Association grade, sex, race, or having undergone a neurosurgical procedure.CONCLUSIONSA standardized protocol in which LMWH is given to patients with SCI within 24 hours of injury is effective in keeping venous thromboembolism at the lower end of the reported range, and is safe, with a zero rate of adverse bleeding events. |
| Databáze: | OpenAIRE |
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