BACKGROUND: The risk of venous thromboembolism is high after spinal cord injury (SCI). This prospective, multicenter study compared unfractionated heparin (UFH) plus intermittent pneumatic compression (IPC) to enoxaparin alone as thromboprophylaxis after SCI. METHODS:Patients with acute SCI were randomly assigned to receive either UFH, 5,000 U every 8 hours, in combination with IPC or enoxaparin, 30 mg every 12 hours. Outcome measures were deep vein thrombosis, pulmonary embolism, and major bleeding after 2 weeks of prophylaxis. RESULTS: Among 107 assessable patients, the incidence of venous thromboembolism was 63.3% with UFH-IPC versus 65.5% with enoxaparin (p = 0.81). The incidence of PE was 18.4% with UFH-IPC versus 5.2% with enoxaparin (p = 0.03). Among all randomized patients, the incidence of major bleeding was 5.3% with UFH-IPC versus 2.6% with enoxaparin (p = 0.14). CONCLUSION: In the acute treatment phase after SCI, safety and thromboprophylactic efficacy were generally similar with UFH-IPC and enoxaparin.
RCT Entities:
BACKGROUND: The risk of venous thromboembolism is high after spinal cord injury (SCI). This prospective, multicenter study compared unfractionated heparin (UFH) plus intermittent pneumatic compression (IPC) to enoxaparin alone as thromboprophylaxis after SCI. METHODS:Patients with acute SCI were randomly assigned to receive either UFH, 5,000 U every 8 hours, in combination with IPC or enoxaparin, 30 mg every 12 hours. Outcome measures were deep vein thrombosis, pulmonary embolism, and major bleeding after 2 weeks of prophylaxis. RESULTS: Among 107 assessable patients, the incidence of venous thromboembolism was 63.3% with UFH-IPC versus 65.5% with enoxaparin (p = 0.81). The incidence of PE was 18.4% with UFH-IPC versus 5.2% with enoxaparin (p = 0.03). Among all randomized patients, the incidence of major bleeding was 5.3% with UFH-IPC versus 2.6% with enoxaparin (p = 0.14). CONCLUSION: In the acute treatment phase after SCI, safety and thromboprophylactic efficacy were generally similar with UFH-IPC and enoxaparin.
Authors: Michael K Gould; David A Garcia; Sherry M Wren; Paul J Karanicolas; Juan I Arcelus; John A Heit; Charles M Samama Journal: Chest Date: 2012-02 Impact factor: 9.410
Authors: S Matsumoto; K Suda; S Iimoto; K Yasui; M Komatsu; C Ushiku; M Takahata; Y Kobayashi; Y Tojo; K Fujita; A Minami Journal: Spinal Cord Date: 2015-02-03 Impact factor: 2.772
Authors: Robert W Teasell; Jane T Hsieh; Jo-Anne L Aubut; Janice J Eng; Andrei Krassioukov; Linh Tu Journal: Arch Phys Med Rehabil Date: 2009-02 Impact factor: 3.966
Authors: Scott Worley; Christine Short; Jeff Pike; David Anderson; Jo-Anne Douglas; Kara Thompson Journal: J Spinal Cord Med Date: 2008 Impact factor: 1.985