Role of Screening Tests for Deep Venous Thrombosis in Asymptomatic Adults With Acute Spinal Cord Injury

Abstract

There is insufficient evidence to support (or refute) a recommendation for routine screening for DVT in adults with acute traumatic SCI under thromboprophylaxis. However, there is level II-2 evidence that screening could detect asymptomatic DVT in 22.7% of those individuals. Although additional investigation is needed, we hypothesize that weekly screening for DVT during the first 13 weeks post-SCI could detect most of the asymptomatic DVT events in this patient population. D-Dimer, ultrasound, and MR venography could be considered as potentially useful screening tests for DVT in the SCI population in future research studies.

Komplikasjoner etter kronisk ryggmargsskade

“…Dette kan utgjøre en økt risiko for venøs tromboembolisme hos spinalskadede. I enkelte studier konkluderer man med at personer med ryggmargsskade rutinemessig bør screenes for venetrombose (26). Klinisk brukes ultralyd, CT, MR og biokjemiske markører (for eksempel D-dimer) kun diagnostisk.…”

Prevention of VTE in Nonsurgical Patients

“…Indirect evidence from hospitalized orthopedic patients 59 and spinal cord injury patients 60 suggests that routine screening is not of benefi t to reduce symptomatic VTE events. For example, in a population of patients who had joint arthroplasty and were receiving warfarin prophylaxis, screening compression ultrasonography with subsequent treatment of identifi ed asymptomatic DVT did not reduce the rate of subsequent symptomatic VTE.…”

Pharmacological prophylaxis for deep vein thrombosis in acute spinal cord injury: an Indian perspective

“…14 Critics suggest that the most important factor may be lack of awareness and proper studies on incidence of DVT in SCI. Another factor that affects the incidence of DVT is the mode of screening, whether routine screening 20 is carried out in all patients with SCI or only in patients who exhibit signs and symptoms of DVT. 9 The lower reported incidence of DVT in our country may be due to the lack of routine screening of patients with SCI for DVT, and it has been proved by studies that majority of patients with DVT in SCI are asymptomatic and serial calf measurements and clinical signs and symptoms are a poor predictor of DVT in patients with SCI.…”