Effects of Four-Week Rehabilitation Program on Hemostasis Disorders in Patients with Spinal Cord Injury

Mackiewicz−Milewska, Magdalena; Cisowska-Adamiak, Małgorzata; Rość, Danuta; Głowacka-Mrotek, Iwona; Świątkiewicz, Iwona

doi:10.3390/jcm9061836

Cited by 4 publications

(5 citation statements)

References 45 publications

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“…Anticoagulation therapy can decrease the VTE formation risk after SCI [ 40 ], or spinal surgery [ 41 ]. Rehabilitation treatment could also reduce the DVT risk formation in patients with SCI [ 42 ]. The participated in our study did not receive rehabilitation treatment before being enrolled in the rehabilitation medicine department.…”

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

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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.

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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

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“…D-dimer testing in patients with clinical suspicion of DVT is widely used; however, the sensitivity of D-dimer testing for the diagnosis of DVT after SCI has been shown to be 78%, and its specificity is 40%, with a negative predictive value of 92% [ 28 ]. In patients after SCI, especially during the early post-trauma period, the level of D-dimer is usually high in patients both with DVT and without [ 29 ]. In the present study, the median level of D-dimer exceeded the normal range in the entire study group and in patients within 6 months since SCI.…”

Section: Discussionmentioning

confidence: 99%

“…The high risk of VTE complications in SCI patients is associated with several factors including venous stasis resulting from immobilization, paresis or paralysis, decreased muscle contractility, as well as previous VTE, older age, infections, and hemostasis disorders [ 2 , 4 , 6 , 21 , 29 , 33 ]. In our study, the risk of DVT appeared to be higher in SCI patients at older age as well as those with flaccid paresis of the lower limbs, AIS C, lumbosacral segment injury, and urinary tract infections.…”

Section: Discussionmentioning

confidence: 99%

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

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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.

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“…NMSOD-mediated spinal cord injury results in varying degrees of disability that requires rehabilitation[ 14 , 15 ]. Patients with spinal cord injury frequently exhibit motor and sensory dysfunction in the limbs, as well as lack of control over defecation and urination.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation and pharmacotherapy of neuromyelitis optica spectrum disorder: A case report

Wang

Xia

Yang

et al. 2021

WJCC

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BACKGROUND Neuromyelitis optica spectrum disorder (NMOSD) is a demyelinating autoimmune disease that affects the central nervous system. It typically manifests as optic neuritis or extensive longitudinal myelitis, with or without the presence of anti-aquaporin protein 4 autoantibodies (immunoglobulin G). CASE SUMMARY We report the case of a 45-year-old woman with a history of Sjogren's syndrome who was diagnosed with NMOSD accompanied by spinal cord injury and left calf intermuscular vein thrombosis. The patient received hormone shock and gamma globulin therapy in the acute phase and standard rehabilitation treatment during convalescence. Upon discharge, the patient was able to control urination and defecation, stand independently, and walk short distances with the aid of a walker. CONCLUSION This case suggests that pharmacotherapy and standard rehabilitation treatment can improve the prognosis of NMSOD patients.

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Effects of Four-Week Rehabilitation Program on Hemostasis Disorders in Patients with Spinal Cord Injury

Cited by 4 publications

References 45 publications

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

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

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

Rehabilitation and pharmacotherapy of neuromyelitis optica spectrum disorder: A case report

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