title: Deep venous thrombosis in patients with acute cervical spinal cord injury in a Japanese population: assessment with Doppler ultrasonography.
abstract: BACKGROUND
  Deep venous thrombosis (DVT) and pulmonary thromboembolism are major complications in patients with acute spinal cord injury. The incidence of DVT in patients with a spinal cord injury has ranged from 5% to 26% in several countries; however, the incidence in Japan is unknown.
  
  
  METHODS
  We retrospectively assessed 52 patients with acute cervical spinal cord injury. According to the American Spinal Injury Association Impairment Scale (AIS) at admission, 17 patients were grade A, 15 grade B, 17 grade C, and 3 grade D. These patients were assessed for a DVT using color Doppler ultrasonography (US) regardless of whether they were symptomatic. As standard protocol, we perform Doppler US 5 days after injury; however, this retrospective research included patients who were assessed 2-13 days after injury.
  
  
  RESULTS
  In this study, 11 of 52 (21%) patients had DVT. Three patients had DVT of the right leg, six of the left leg, and two of bilateral legs. There were two proximal-type DVTs and nine distal-type DVTs. No patients had a symptomatic thrombopulmonary embolism. In all, 10 of 41 (24%) men had DVT and 1 of 11 (9%) women had DVT (P = 0.26). A total of 7 of 32 (22%) patients who had complete motor palsy (AIS A or B) had DVT, and 4 of 20 (20%) with incomplete motor palsy (AIS C or D) had DVT (P = 0.58). DVT was found 2-13 days after injury.
  
  
  CONCLUSIONS
  In this study of the Japanese population, 11 of 52 (21%) patients with acute cervical spinal cord injury had DVT. Several studies showed there were no differences in the incidence of DVT between patients with complete or incomplete palsy, and our study showed the same results. Many asymptomatic patients had DVT, so asymptomatic patients should not be neglected.
authors: Department of Orthopaedic Surgery, Kobe Red Cross Hospital, 1-3-1 Wakihamakaigan-douri, Kobe, Hyogo, Japan.
authors: Yoshihisa
authors: Y
authors: Sugimoto
authors: Yasuo
authors: Y
authors: Ito
authors: Masao
authors: M
authors: Tomioka
authors: Masato
authors: M
authors: Tanaka
authors: Yasuhiro
authors: Y
authors: Hasegawa
authors: Kie
authors: K
authors: Nakago
authors: Yukihisa
authors: Y
authors: Yagata
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002574:Cervical Vertebrae; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*