Venous thromboembolism and anticoagulation in spinal cord lesion rehabilitation inpatients: A 10-year retrospective study

Vadim Bluvshtein, Amiram Catz*, Ala Mahamid, Keren Elkayam, Dianne Michaeli, Lilach Front, Adi Kfir, Ilana Gelernter, Elena Aidinoff

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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 40 mg/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.

Original languageEnglish
Pages (from-to)143-153
Number of pages11
JournalNeuroRehabilitation
Volume53
Issue number1
DOIs
StatePublished - 2023

Funding

FundersFunder number
Loewenstein Rehabilitation Medical CenterKM600010309

    Keywords

    • Deep vein thrombosis
    • anticoagulation
    • prophylaxis
    • pulmonary embolism
    • spinal cord lesions

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