Xin Yu1, Wei Liu1, Hao-Wei Zhang1. 1. Pingmei Shenma Medical Group General Hospital, Pingdingshan 467000, Henan, China.
Abstract
OBJECTIVE: To explore the high-risk factors of deep vein thrombosis (DVT) formation in patients after spinal cord injury (SCI) and to provide some reference value for the prevention of DVT. METHODS: Eighty-five patients with spinal cord injury caused by thoracolumbar burst fracture from January 2016 to December 2017 were selected as subjects. All patients were followed up for 6 months, of which 5 cases were lost and 80 cases were finally included. According to whether there was deep vein thrombosis, the patients were divided into DVT group (35 cases) and control group (45 cases). The clinical data were statistically analyzed by SPSS 22.0 statistical software, and the high-risk factors of spinal cord injury were analyzed by multivariate Logistic regression. RESULTS: Thirty-five of the 80 patients with spinal cord injury developed deep venous thrombosis (incidence rate was about 43.7%). The average age of DVT group [(47.77±10.76) years ] was higher than that of non-DVT group [(37.35±10.20) years ], and there was a significant difference between two groups (χ2=19.56, P<0.000). Patients with body mass index≥28 kg/m2, combined with diabetes mellitus, smoking history, no limb pressure therapy and ankle pump exercise had a high incidence of DVT. The incidence of ASIA grade A in the spinal cord injury was higher in the DVT group (48.5%) than in the non-DVT group (20%) (P<0.05). The ROC curve was drawn by MedCalc 15.8 software : when the age was more than 45 years old, the incidence of deep venous thrombosis was higher, the specificity was 84.4%, and the sensitivity was 72.6%. Multivariate Logistic regression analysis showed the following factors : patient age >45 years [OR=1.665, 95% CI (1.102-2.516)], diabetes history [OR=3.273, 95% CI (1.291-8.295)], smoking history [OR=3.302, 95% CI (1.267-8.605)], spinal cord injury ASIA grade A [OR=5.736, 95% CI (3.152-11.74)], non-limb air pressure therapy and ankle pump exercise [ OR=3.013, 95% CI (0.116-0.789)] was statistically significant (P<0.05) and was a high risk factor for deep vein thrombosis. CONCLUSION: The incidence of DVT is still high in patients with spinal cord injury after surgery. When one or more risk factors such as age >45 years, history of diabetes, smoking history, and ASIA grade A of spinal cord injury is present, preventive measures should be taken in advance, it is of great significance to prevent the formation of deep vein thrombosis.
OBJECTIVE: To explore the high-risk factors of deep vein thrombosis (DVT) formation in patients after spinal cord injury (SCI) and to provide some reference value for the prevention of DVT. METHODS: Eighty-five patients with spinal cord injury caused by thoracolumbar burst fracture from January 2016 to December 2017 were selected as subjects. All patients were followed up for 6 months, of which 5 cases were lost and 80 cases were finally included. According to whether there was deep vein thrombosis, the patients were divided into DVT group (35 cases) and control group (45 cases). The clinical data were statistically analyzed by SPSS 22.0 statistical software, and the high-risk factors of spinal cord injury were analyzed by multivariate Logistic regression. RESULTS: Thirty-five of the 80 patients with spinal cord injury developed deep venous thrombosis (incidence rate was about 43.7%). The average age of DVT group [(47.77±10.76) years ] was higher than that of non-DVT group [(37.35±10.20) years ], and there was a significant difference between two groups (χ2=19.56, P<0.000). Patients with body mass index≥28 kg/m2, combined with diabetes mellitus, smoking history, no limb pressure therapy and ankle pump exercise had a high incidence of DVT. The incidence of ASIA grade A in the spinal cord injury was higher in the DVT group (48.5%) than in the non-DVT group (20%) (P<0.05). The ROC curve was drawn by MedCalc 15.8 software : when the age was more than 45 years old, the incidence of deep venous thrombosis was higher, the specificity was 84.4%, and the sensitivity was 72.6%. Multivariate Logistic regression analysis showed the following factors : patient age >45 years [OR=1.665, 95% CI (1.102-2.516)], diabetes history [OR=3.273, 95% CI (1.291-8.295)], smoking history [OR=3.302, 95% CI (1.267-8.605)], spinal cord injury ASIA grade A [OR=5.736, 95% CI (3.152-11.74)], non-limb air pressure therapy and ankle pump exercise [ OR=3.013, 95% CI (0.116-0.789)] was statistically significant (P<0.05) and was a high risk factor for deep vein thrombosis. CONCLUSION: The incidence of DVT is still high in patients with spinal cord injury after surgery. When one or more risk factors such as age >45 years, history of diabetes, smoking history, and ASIA grade A of spinal cord injury is present, preventive measures should be taken in advance, it is of great significance to prevent the formation of deep vein thrombosis.