Abstract
Introduction: the risk of venous thromboembolism (VTE) after Spinal injuries was largely realised but the true incidence of which is still variable and unclear. Abstract Patients & method: We retrospectively reviewed the charts of 374 consecutive patients who sustained traumatic spinal injury and admitted acutely to a comprehensive care spinal injuries centre. 159 patients had spinal trauma with spinal cord injury (SCI) and 215 were neurologically intact. The majority of these patients were treated non-surgically and received the same thromboprophylactic regimen started within a median of 2 days post injury. The incidence of clinical VTE (deep Vein thrombosis DVT & Pulmonary Embolism PE) was determined and some risk factors discussed. Results: Among the neurologically intact group one patient developed clinical PE (0.5%). Out of 159 patients with SCI, 23 developed clinically evident VTE (14.5%), 15 had DVT (11.9%), 4 PE (5%) and 4 had both DVT & PE). There was no fatality. Complete SCI lesions were associated with higher incidence of VTE compared to incomplete lesions, 17.6 % & 11% respectively (p<0.001). We found two peaks of thromboembolic episodes the first during the first 2 weeks after injury (30% of cases), the second after the 8th week post injury (38% of cases). Conclusion: Spinal cord injury is associated with high risk of venous thromboembolism and the risk increases with the severity of cord insult. While spinal column injury is shown to be associated with a relatively low risk in this series. The risk is reduced with strict adherence to thromboprophylactic regimen which we suggest continuing for at least 12 weeks for SCI patients. Keywords: Spinal injury; Spinal cord injury; Pulmonary embolism; Deep vein thrombosis; Venous thromboembolism; Thromboprophylaxis arabic 13 English 84