Deep venous thrombosis in patients with acute cervical spinal cord injury in a Japanese population: assessment with Doppler ultrasonography.
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.
Sugimoto
Yoshihisa
Y
Department of Orthopaedic Surgery, Kobe Red Cross Hospital, 1-3-1 Wakihamakaigan-douri, Kobe, Hyogo, Japan.
Ito
Yasuo
Y
Tomioka
Masao
M
Tanaka
Masato
M
Hasegawa
Yasuhiro
Y
Nakago
Kie
K
Yagata
Yukihisa
Y
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*