Exploratory analysis of factors associated with venous thromboembolism in Victorian acute traumatic spinal cord-injured patients 2010-2013

Abstract

Study design: A retrospective medical records audit.

Objectives: To investigate the presence of venous thromboembolism (VTE) events following acute traumatic spinal cord injury (SCI) and the association between VTE events and a number of postulated risk factors.

Setting: The state-wide SCI service in Victoria Australia (Victorian Spinal Cord Service) located at Austin Hospital Melbourne Australia.

Methods: A retrospective electronic medical records file audit was performed of all patients admitted to VSCS between 2010 and 2013 with an acute traumatic SCI. The outcome measure was the presence of VTE (deep venous thrombosis (DVT), pulmonary embolism (PE) or both). Data were also collected on a variety of established and postulated risk factors for VTE post SCI.

Results: VTE events occurred in 21.2% of acute SCI patients during the hospitalisation of the patient. Statistically significant associations were found between the presence of VTE events and increased weight, male sex, completeness of motor paralysis, length of stay (LOS), associated pelvic or lower limb fracture and delayed admission to the state-wide spinal cord service.

Conclusion: Further studies are warranted to investigate whether in other SCI centres the risk of VTE in acute SCI patients is similarly associated with the risk factors identified in our study. A study exploring whether giving acute SCI patients of heavier weight a larger dose of chemical thromboprophylaxis is safe and efficacious is also warranted.