Duplex ultrasound screening for deep vein thrombosis in spinal cord injured patients at rehabilitation admission.
OBJECTIVE
To determine the rate of deep vein thrombosis (DVT) newly diagnosed by duplex ultrasound in patients with acute spinal cord injury (SCI) at admission for rehabilitation.


METHODS
Retrospective case-control study.


METHODS
Independent specialized spinal cord rehabilitation hospital.


METHODS
Data were collected from records of 189 SCI patients admitted for rehabilitation over a 1-year period who underwent a duplex scan and were not admitted with a known diagnosis of DVT.


METHODS
A DVT newly diagnosed by duplex ultrasound at rehabilitation admission.


RESULTS
Twenty-two patients (11.6%) had a newly diagnosed DVT at time of admission. Chi-square analysis found no statistically significant relationship between level of injury (tetraplegia vs paraplegia), motor complete (ASIA A and B) versus incomplete status (ASIA C and D), or cause of SCI (traumatic vs nontraumatic injury) in determining a positive or negative duplex result (chi2 = 1.709, p = .191; chi2 = 1.314, p = .252; chi2 = 3.155, p = .076; respectively). Prophylaxis for DVT decreased the risk of developing a DVT: 4.1% of patients administered prophylaxis as compared to 16.4% of patients not given prophylaxis (chi2 = 6.558, p = .01). Only 38.6% of patients transferred to rehabilitation were undergoing DVT prophylaxis.


CONCLUSIONS
The prevalence of DVT in acute SCI patients at admission to rehabilitation is significant. A duplex ultrasound is an important noninvasive technique to screen patients with acute and subacute SCI for DVT on admission to the rehabilitation setting regardless of the completeness, level, or cause of the patients' injury.
Powell
M
M
Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey/New Jersey Medical School, Newark, USA.
Kirshblum
S
S
O'Connor
K C
KC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010343:Patient Admission; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000534:rehabilitation*; D013924:Thrombophlebitis / Q000000981:diagnostic imaging* / Q000534:rehabilitation; D018616:Ultrasonography, Doppler, Duplex