Hemostatic parameters in patients with spinal cord injury in subacute and chronic phase of the rehabilitation

Mackiewicz−Milewska, Magdalena; Kroszczyński, Andrzej C.; Cisowska-Adamiak, Małgorzata; Pyskir, Jerzy; Rość, Danuta; Hagner, Wojciech

doi:10.1080/10790268.2019.1708600

Cited by 7 publications

(8 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may indicate that DVT in group II of patients (3 to 6 months after SCI) developed in the acute period post-injury but was not diagnosed earlier because ultrasound screening was not done and DVT was not fully symptomatic. Our present findings are consistent with our previous study which showed that the level of D-dimer remained high in patients up to 3 months after SCI, with the median of 2540 ng/mL and average value of 4488 ng/mL [ 30 ]. Matsumoto et al [ 5 ] observed very high average D-dimer values of 14,600 ng/mL among patients several days after SCI, which did not differ significantly between groups with and without DVT.…”

Section: Discussionsupporting

confidence: 93%

Usefulness of D-dimer and Ultrasonography Screening for Detecting Deep Vein Thrombosis in Patients with Spinal Cord Injury Undergoing Rehabilitation

Mackiewicz−Milewska

Cisowska-Adamiak

Pyskir

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

Patients with spinal cord injury (SCI) are at an increased risk of deep vein thrombosis (DVT). This study aims at assessing usefulness of D-dimer and compressive Doppler ultrasonography (CDUS) for detecting DVT in patients undergoing rehabilitation at various time-points post-SCI. One-hundred forty-five patients were divided into three groups based on time elapsed since SCI: I (≥3 weeks to 3 months), II (≥3 to 6 months), and III (≥6 months). On admission, D-dimer plasma level measurement and CDUS of the lower limbs venous system were performed. DVT was diagnosed using CDUS in 15 patients (10.3% of entire group), more frequently in group I (22.2% of group) and II (11.7%) compared to group III (1.5%). Most DVT patients received thromboprophylaxis (80%) and were asymptomatic or mildly symptomatic (60%). Median D-dimer was elevated in patients with DVT from all groups, and also patients without DVT from groups I and II, but not group III. D-dimers were higher in patients with DVT than without DVT in the entire group (p = 0.001) and group I (p = 0.02), but not in groups II and III. The risk of DVT in SCI patients undergoing rehabilitation and thromboprophylaxis including asymptomatic or mildly symptomatic cases, is high within 6 months post-injury, and especially within 3 months. Measurement of D-dimer level should be complemented by routine CDUS for detecting DVT within 6 months post-SCI. Over 6 months, the usefulness of D-dimer screening alone is better for DVT detection.

show abstract

Section: Discussionsupporting

confidence: 93%

Usefulness of D-dimer and Ultrasonography Screening for Detecting Deep Vein Thrombosis in Patients with Spinal Cord Injury Undergoing Rehabilitation

Mackiewicz−Milewska

Cisowska-Adamiak

Pyskir

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several patients with SCI were observed to have DVT by Doppler angiography during rehabilitation [ 32 ]. Notably, for sub-acute and even chronic patients with SCI had disturbed coagulation and fibrynolitic system, regardless of whether VTE was formed or not [ 33 ]. Research indicates D-dimer levels in SCI adults were markedly 70% higher in adults with SCI compared with non-injured adults [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Associations of RBC counts and incidence of DVT in patients with spinal cord injury: a five year observational retrospective study

Jinlong,

Cheng,

Chengqi

2024

J Orthop Surg Res

View full text Add to dashboard Cite

Background The role of red blood cell (RBC) counts as potential independent risk factors for deep vein thrombosis (DVT) in patients with spinal cord injury (SCI) remains uncertain. This study aims to clarify the associations between RBC counts and DVT incidence among this population. Methods A retrospective analysis was performed on 576 patients with SCI admitted to the rehabilitation medicine department from January 1, 2017 to December 31, 2021. After exclusions, 319 patients were analyzed, among which 94 cases of DVT were identified. Results Mode of injury, D-dimer and anticoagulant therapy were significant covariates (P < 0.05). Age, fibrinogen, D-dimer, anticoagulant therapy and American Spinal Cord Injury Association impairment scale (AIS) grades were associated with RBC counts and DVT incidence (P < 0.05). Adjusting for these factors, a 1.00 × 10^12/L increase in RBC counts correlated with a 45% decrease in DVT incidence (P = 0.042), revealing a “U” shaped relationship with a pivot at 4.56 × 10^12/L (P < 0.05). Conclusion RBC counts below 4.56 × 10^12/L serve as a protective factor against DVT, while counts above this threshold pose a risk. These findings could inform the development of DVT prevention strategies for patients with SCI, emphasizing the need for targeted monitoring and management of RBC counts.

show abstract

“…The coagulation-brinolytic axis plays a central role in atherosclerosis and thrombotic events (8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

“…Increased activity of the coagulation system and enhanced brin deposition if not counteracted with brinolysis and the degradation of brin deposit at sites of vascular injury or on atheromatous plaques precipitate vascular events (13). Indeed, coagulation and brinolytic dysfunction underlie ischemic stroke and MI (8)(9)(10)(11)(12)(13)(14)(15). Activation of coagulation cascade factors VII, VIII, and X amplify thrombin generation, brin deposition, and are independently associated with atherosclerotic disease and major vascular events later in life in the general population (12,13).…”

Section: Introductionmentioning

confidence: 99%

“…In context of future cardiovascular disease, undiagnosed, indolent, subclinical coagulation and brinolytic dysfunction early after injury, may also be an important contributor to major vascular events decades later in life. Studies assessing coagulation and brinolytic factors in individuals with subacute and chronic SCI have demonstrated con icting results (11,(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Development of a hypercoagulable-hypofibrinolytic state early after spinal cord injury

Park

Garcia²,

Greiner³

et al. 2022

Preprint

View full text Add to dashboard Cite

Study Design: Cross sectional study. Objectives: To determine whether spinal cord injury (SCI) is associated with adverse changes in coagulation and fibrinolytic factors that underlie thrombogenesis and contribute to atherothrombotic events such as myocardial infarctions (MI) and strokes. Setting: Adults with subacute SCI and non-injured community dwelling adults. Methods: Thirty young and middle-aged (20-58 years) adults were studied: 14 non-injured (11M/4F) and 16 with subacute SCI (13M/3F; time since injury: 11.8±5.3 wk). Circulating markers of coagulation [von Willebrand factor (vWf) and factors VII, VIII, and X], the fibrinolytic system [tissue-type plasminogen activator (t-PA), and plasminogen activator inhibitor-1 (PAI-1) antigen and activity], and fibrin formation (D-dimer) were determined by enzyme immunoassay. Results: Circulating levels of coagulation factors VII, VIII and X were significantly higher (~20-45%) in the adults with SCI than non-injured adults; whereas, vWf was similar between groups. Fibrinolytic markers were adversely disrupted with SCI with t-PA antigen, PAI-1 antigen and PAI-1 activity were markedly higher (~50-800%; P<0.05) in adults with SCI compared with non-injured adults. The molar concentration ratio of active t-PA to PAI-1 was significantly higher (~350%) in adults with SCI. Concordant with coagulation cascade activation and fibrinolytic system inhibition, D-dimer concentrations were markedly ~70% higher (P<0.05) in adults with SCI compared with non-injured adults. Conclusions: Subacute tetraplegic motor complete SCI is associated with a prothrombotic hemostatic profile. Adverse changes in the coagulation cascade and fibrinolytic system appear to occur early after injury and may contribute to the increased atherothrombotic risk in adults living with SCI.

show abstract

Hemostatic parameters in patients with spinal cord injury in subacute and chronic phase of the rehabilitation

Abstract: Objective: The goal of this study was to measure hemostatic markers after SCI. Design: Assesing changes in coagulation and fibrynilitic system in SCI patients in different time post injury to Cross-sectional study.

Cited by 7 publications

References 50 publications

Usefulness of D-dimer and Ultrasonography Screening for Detecting Deep Vein Thrombosis in Patients with Spinal Cord Injury Undergoing Rehabilitation

Usefulness of D-dimer and Ultrasonography Screening for Detecting Deep Vein Thrombosis in Patients with Spinal Cord Injury Undergoing Rehabilitation

Associations of RBC counts and incidence of DVT in patients with spinal cord injury: a five year observational retrospective study

Development of a hypercoagulable-hypofibrinolytic state early after spinal cord injury

Contact Info

Product

Resources

About