Deep Vein Thrombosis in Patients with Severe Motor and Intellectual Disabilities

Ohmori, Harunori; Ochi, Fumihiro; Tanuma, Naoyuki; Ohnuki, Eiichi; Yamasaki, Masami; Takesue, Hiroko; Kan, Miki; Matsumoto, Nobuo; Sumimoto, Ryo; Harada, Akira

doi:10.3400/avd.oa.13-00090

Cited by 11 publications

(7 citation statements)

References 17 publications

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“…A longer duration with CSM was also associated with DVT in CSM; patients with preoperative DVT had CSM for a significantly longer duration than patients without DVT (7.56 vs 4.0 months; P = 0.03). These observations are consistent with those of a study by Ohmori et al, [ 11 ] which found that 34.8% of patients with severe motor disabilities had DVT; this may have reflected their restricted mobility and tendency to be bedridden for long periods. Moreover, a study by Hamidi and Riazi [ 12 ] showed that postsurgical recumbence duration was an independent risk factor for VTE after spinal surgery.…”

Section: Discussionsupporting

confidence: 93%

Preoperative deep vein thrombosis in patients with cervical spondylotic myelopathy scheduled for spinal surgery

Liu

Sun

et al. 2016

Medicine

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Introduction:The prevalence of deep vein thrombosis (DVT) and its risk factors in patients with cervical spondylotic myelopathy (CSM) before spinal surgery are poorly understood. We investigated this association with a retrospective cross-sectional study.Patients concerns:The study cohort consisted of all consecutive patients with CSM who were scheduled for spinal surgery at our institution from 2013 to 2015. DVT was defined as an intraluminal filling defect in a lower extremity vein identified by Doppler ultrasonography.Outcomes:Of the 396 patients with CSM, 16 (4%) had DVT. Compared with patients without preoperative DVT, patients with preoperative DVT were older (62.75 ± 8.79 vs 53.03 ± 10.95 years, P = 0.001), had higher D-dimer concentrations (2.23 ± 4.15 vs 0.43 ± 0.90 mg/L, P = 0.04), had experienced longer duration of CSM (7.56 ± 7.08 vs 4.01 ± 6.37 months, P = 0.03), had lower Japanese Orthopaedic Association lower limb motor dysfunction scores (1.68 ± 1.25 vs 2.54 ± 0.91, P = 0.01), and had a history of ischemic cardiovascular events (33.3% vs 2.1%, P = 0.02). The area under the curve for the ability of D-dimer levels to predict DVT was 0.858 (95% confidence interval: 0.764–0.951; P < 0.0001). A D-dimer level of 0.54 mg/L detected DVT with a sensitivity and specificity of 87.5% and 83.2%, respectively. Abnormal D-dimer levels and ischemic cardiovascular events history were independent predictors of DVT.Conclusion:Patients with CSM who were scheduled for surgery often presented with preoperative DVT. Preoperative vascular screening should be considered for patients with CSM, especially for those who are older, have had longer duration of CSM, have poor lower limb mobility, and have a heart disease history. Inferior vena cava filter insertion and anticoagulation treatments should be considered for CSM patients with preoperative DVT.

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Section: Discussionsupporting

confidence: 93%

Preoperative deep vein thrombosis in patients with cervical spondylotic myelopathy scheduled for spinal surgery

Liu

Sun

et al. 2016

Medicine

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“…Users with pain requiring further investigation/management, or influencing the EPIOC prescription were recorded as "problematic pain," as noted by Novak et al (2012). Those noted by others as being disability related were spinal deformities (Kembhavi et al, 2011; kyphus, scoliosis, and kyphoscoliosis were all noted as kyphoscoliosis), osteoporosis (Kim et al, 2015), oedema/cellulitis (Zaffuto-Sforza, 2005), thromboembolism (Ohmori et al, 2013), pelvic obliquity (Krautwurst et al, 2013), and pressure sores (Janicki, Henderson, & Rubin, 2008). Conditions classified as comorbidities were those considered unrelated to CP.…”

Section: Methodsmentioning

confidence: 99%

Problematic clinical features of children and adults with cerebral palsy who use electric powered indoor/outdoor wheelchairs: A cross-sectional study

Frank

Souza

2016

Assistive Technology

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This article aims to describe the clinical features of electric powered indoor/outdoor wheelchair (EPIOC) users with cerebral palsy (CP) that are problematic to optimal prescription and to explore comorbidities, features of CP, and conditions secondary to disability impacting on equipment provision for children and adults. The method is a cross-sectional study of EPIOC users (n = 102) with a primary diagnosis of CP. This is a retrospective review of electronic and case note records of EPIOC recipients attending a specialist wheelchair service in 2007-2008. Records were reviewed by a rehabilitation consultant. Data were extracted under three themes; demographic, diagnostic/clinical and wheelchair factors. There were 48 males mean age 27.5 (range 8-70, SD 13.9) years and 54 females, mean age 29.5 (range 7-68, SD 14.6) years with CP. Sixteen comorbidities, nine features of CP, and five features of disability influenced wheelchair prescription. Sixty-four users were provided with specialized seating (SS) and 47 with tilt-in-space (TIS) seats. Complex controls were provided to 16 users, 12 tray-mounted. The majority of users had both SS and TIS. Powered wheelchair prescription has important therapeutic roles in clinical management in addition to enhancing mobility, independence and participation. Clinical features such as spasticity and problematic pain appeared less well managed in adults than in children.

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“…Hypotheses for his development of DVT include additional effects of kinking in vessels, and this may have implications for patients with contractured lower limbs [15] for whom DVT risk may be increased, but regular screening may be limited by their access to care.…”

Section: Discussionmentioning

confidence: 99%

When Computers Can Kill—Two Unusual Cases of “E-Thrombosis”

Doctor¹,

Seth²

2018

IJCM

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Deep vein thrombosis (DVT) is a common and potentially fatal vascular event when it leads to pulmonary embolism. Occurring as part of the broader phenomenon of Venous Thromboembolism (VTE), DVT classically arises when Virchow's triad of hypercoagulability, changes in blood flow (e.g. stasis) and endothelial dysfunction, is fulfilled. Although such immobilisation is most often seen in bedbound patients and travellers on long distance flights, there is increasing evidence that prolonged periods of work or leisure related to using computers while seated at work desks, is an independent risk factor. In this report, we present two cases of "e-thrombosis" from prolonged sitting while using a computer.

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Deep Vein Thrombosis in Patients with Severe Motor and Intellectual Disabilities

Cited by 11 publications

References 17 publications

Preoperative deep vein thrombosis in patients with cervical spondylotic myelopathy scheduled for spinal surgery

Preoperative deep vein thrombosis in patients with cervical spondylotic myelopathy scheduled for spinal surgery

Problematic clinical features of children and adults with cerebral palsy who use electric powered indoor/outdoor wheelchairs: A cross-sectional study

When Computers Can Kill—Two Unusual Cases of “E-Thrombosis”

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