title: Venous thromboembolism after spinal cord injury: incidence, time course, and associated risk factors in 16,240 adults and children.
abstract: OBJECTIVE
  To analyze the incidence of venous thromboembolism (VTE) after spinal cord injury (SCI).
  
  
  METHODS
  Retrospective cohort analysis of all SCI cases (16,240) in California from 1991 through 2001.
  
  
  METHODS
  All public hospitals in California.
  
  
  METHODS
  Subjects (cases) coded as having complete or incomplete SCI.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Diagnosis of VTE or death within 91 days of the day of hospital admission.
  
  
  RESULTS
  For all cases, the 91-day cumulative incidence of VTE was 5.4%. In a multivariate model, significant predictors of VTE included male sex (odds ratio [OR]=1.4; 95% confidence interval [CI], 1.2-1.7), African-American race (OR=1.6; 95% CI, 1.3-1.9), complete paraplegia versus tetraplegia (OR=1.8; 95% CI, 1.4-2.3), and presence of 3 or more comorbid conditions versus none (OR=1.6; 95% CI, 1.3-2.1). Age less than 14 years was predictive of not developing VTE (OR=0.2; 95% CI, 0.1-0.7). The incidence of VTE did not change significantly over the 11-year time period (P=.07), and VTE was not a significant predictor of death in the first 91 days after hospitalization.
  
  
  CONCLUSIONS
  The incidence of VTE in SCI patients in California did not change between 1991 and 2001. We identified specific risk factors for VTE. Further studies are needed to determine if prompt initiation of medical prophylaxis in high risk subjects reduces the incidence of symptomatic VTE.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Center for Health Services Research in Primary Care, University of California, Davis, CA, USA.
authors.forename: Tracey
authors.initials: T
authors.lastname: Jones
authors.forename: Viviane
authors.initials: V
authors.lastname: Ugalde
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
authors.forename: Hong
authors.initials: H
authors.lastname: Zhou
authors.forename: Richard H
authors.initials: RH
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000401:mortality; D020246:Venous Thrombosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control