Prevalence of deep venous thrombosis in patients with chronic spinal cord injury

Abstract

From a group of 229 patients with chronic spinal cord injury (SCI) who were admitted to an SCI Service of a Veterans Affairs Medical Center, a prospective study was performed to determine the prevalence of deep venous thrombosis (DVT) using radionuclide venography on 43 patients in whom this diagnosis was entertained by clinical examination. By physical examination of the total population of 229 patients on admission, patients were selected and then divided into two groups: the clinically DVT-free group (22 patients) and the clinically DVT-suspected group (21 patients). In the clinically DVT-free group, two cases of chronic DVT (9.1%) were detected incidentally. In the clinically DVT-suspected group, 2 cases of chronic DVT (9.5%) and 4 cases of acute DVT (19.0%) were found. In one subject in the DVT-free group, a false positive radionuclide study was suspected and proven by contrast venography. In the 43 patients studied by radionuclide venography, the prevalence of acute DVTs was 9.3% and chronic DVTs, 9.3% (7.0% "true" chronic DVTs). No subjects in the clinically DVT-free group had an acute DVT. Five of 8 DVTs (62.5%) were detected greater than 6 years after SCI and 3 of 4 (75%) of the acute DVTs developed 17 to 33 years after SCI. Thus, the prevalence of acute DVT cases in this chronically immobilized cohort was found to be relatively low when compared with that in prior reports in those with acute SCI, but the prevalence rate of acute DVT cases in the study herein is similar to or lower than that found in the surgical or medical nonambulatory, non-SCI population.