Key result
Routine duplex ultrasound screening detected DVT in 16.4% of patients with acute traumatic spinal cord injury at rehabilitation admission, with older age and severe injury as independent risk factors.
Why the study?
The study was conducted to determine the prevalence of DVT detected by routine duplex screening and identify associated risk factors in patients with traumatic SCI admitted to rehabilitation.
Observational (n=189)
Routine duplex ultrasound screening in acute traumatic spinal cord injury patients reveals a 16.4% prevalence of DVT, with older age and severe neurological impairment as key risk factors.
Supports DVT screening at rehab admission in acute SCI; hypothesis-generating and requires prospective validation.
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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Hon et al. (2019) conducted an observational in acute traumatic spinal cord injury (n=189). Duplex scan of lower extremities was evaluated on positive duplex screening for either any DVT (distal and/or proximal) or proximal DVT. Routine duplex ultrasound screening detected DVT in 16.4% of patients with acute traumatic spinal cord injury at rehabilitation admission, with older age and severe injury as independent risk factors.
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