Last updated March 15, 2022

Deep Venous Thrombosis and Thromboembolism in Patients With Cervical Spinal Cord Injuries

RECOMMENDATIONS

Prophylaxis

Prophylactic treatment of venous thromboembolism (VTE) in patients with severe motor deficits due to spinal cord injury is recommended. (Level I)
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The use of low molecular weight heparins, rotating beds, or a combination of modalities is recommended as a prophylactic treatment strategy. (Level I)
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Low dose heparin in combination with pneumatic compression stockings or electrical stimulation is recommended as a prophylactic treatment strategy. (Level I)
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Low dose heparin therapy alone is not recommended as a prophylactic treatment strategy. (Level II)
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Oral anticoagulation alone is not recommended as a prophylactic treatment strategy. (Level II)
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Early administration of VTE prophylaxis (within 72 hours) is recommended. (Level II)
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A 3-month duration of prophylactic treatment for deep vein thrombosis (DVT) and pulmonary embolism (PE) is recommended. (Level II)
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Vena cava filters are not recommended as a routine prophylactic measure, but are recommended for select patients who fail anticoagulation or who are not candidates for anticoagulation and/or mechanical devices. (Level III)
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Diagnosis

Duplex Doppler ultrasound, impedance plethysmography, venous occlusion plethysmography, venography, and the clinical examination are recommended for use as diagnostic tests for DVT in the spinal cord injured population. (Level III)
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Recommendation Grading

Overview

Title

Deep Venous Thrombosis and Thromboembolism in Patients With Cervical Spinal Cord Injuries

Authoring Organization

Publication Month/Year

December 1, 2013

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

 The purpose of this current evidence-based review is to update, evaluate, and rank the literature on the methods of prevention, identification, and treatment of VTE complications in patients following acute cervical spinal cord injury published since 2002

Target Patient Population

Patients following acute cervical spinal cord injury

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Emergency care, Hospital, Outpatient

Intended Users

Nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D054556 - Venous Thromboembolism, D020246 - Venous Thrombosis, D013116 - Spinal Cord, D011315 - Preventive Medicine, D011655 - Pulmonary Embolism, D013119 - Spinal Cord Injuries, D066193 - Cervical Cord

Keywords

spinal cord injury, deep vein thrombosis, pulmonary embolism, venous embolism

Source Citation

Neurosurgery, Volume 72, Issue suppl_3, March 2013, Pages 244–254, https://doi.org/10.1227/NEU.0b013e31827728c0