The prevalence of pulmonary embolism in chronically paralyzed subjects: a review of available evidence

Frisbie, J H; Sharma, Gaurav

doi:10.1038/sc.2011.154

Cited by 5 publications

(3 citation statements)

References 36 publications

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“…While most studies have concentrated on the incidence of PE and DVT in the acute phase of SCI, research on the sub-acute and chronic rehabilitation phases are lacking [12]. Thromboprophylaxis is given in the acute phase based on observational evidence that PE is a significant cause of death in the first 90 days post injury [1013].…”

Section: Introductionmentioning

confidence: 99%

Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature

et al. 2016

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To review the evidence of thromboembolism incidence and prophylaxis in the sub-acute phase of spinal cord injury (SCI) 3–6 months post injury. All observational and experimental studies with any length of follow-up and no limitations on language or publication status published up to March 2015 were included. Two review authors independently selected trials for inclusion and extracted data. Outcomes studied were incidence of pulmonary embolism (PE) and deep vein thrombosis (DVT) in the sub-acute phase of SCI. The secondary outcome was type of thromboprophylaxis. Our search identified 4305 references and seven articles that met the inclusion criteria. Five papers reported PE events and three papers reported DVT events in the sub-acute phase of SCI. Studies were heterogeneous in populations, design and outcome reporting, therefore a meta-analysis was not performed. The included studies report a PE incidence of 0.5%–6.0% and DVT incidence of 2.0%–8.0% in the sub-acute phase of SCI. Thromboprophylaxis was poorly reported. Spinal patients continue to have a significant risk of PE and DVT after the acute period of their injury. Clinicians are advised to have a low threshold for suspecting venous thromboembolism in the sub-acute phase of SCI and to continue prophylactic anticoagulation therapy for a longer period of time.

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Section: Introductionmentioning

confidence: 99%

Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature

et al. 2016

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“…Proto je třeba při výběru vozíku a jeho nastavení vždy zohlednit klinickou situaci pa cienta [3], abychom minimalizovali sekundární komplikace a ještě lépe jim předcházeli. Projevují se jak v oblasti postury -pánve, dolních končetin, trupu a hlavy, tak v nestabilitě sedu, zhoršené propulzi, zvýšení bolestivosti, změně respiračních parametrů, změně cirkulace v oblasti dolních končetin s rizikem vzniku tromboembolické nemoci [4], zhoršením soběstačnosti a zvýšením rizika vzniku dekubitů. Důsledkem je imobilizace pa cienta, psychická deprivace, ztráta motivace, zhoršení kvality života, sociální exkluze a zvýšená závislost na sociálním systému.…”

Section: úVodunclassified

The Relevance of Pressure Mapping System in Wheelchair Mobility

Vašíčková¹,

Sieglová²,

Mášek³

2016

Cesk Slov Neurol N

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Význam tlakové mapy (pres sure mapp ing system) pro pa cienty s mobilitou na vozíku The Relevance of Pres sure Mapp ing System in Wheelchair Mobility Souhrn Cíl: Cílem je zhodnotit využití tlakové mapy (Pres sure Mapp ing System; PMS) při komplexním vyšetření spinálních pa cientů s mobilitou na vozíku. Soubor a metodika: Zpracován byl soubor 29 pa cientů, kteří byli vyšetřeni v rámci spinální ambulance celoživotní péče FN Brno v roce 2015 (podrobná anamnéza, klinické vyšetření sedu ve vozíku a vleže a vsedě na lehátku, vyšetření PMS, fotodokumentace sedu ve vozíku). Výsledky: Z celkového počtu 21 mužů a osmi žen utrpělo lézi míšní 26 pa cientů úrazem. U jednoho muže a dvou žen se jednalo o neúrazovou etiologii. Všichni se pohybovali na mechanickém vozíku. Rozložení tlaku na sedacím polštáři u jednotlivých pa cientů ukázalo, že u 10 byl tlak pod hrboly sedacích kostí pod 100 m m Hg (průměr 80 ± 24 m m Hg vlevo, 91 ± 24 m m Hg vpravo). U 12 pa cientů byla jednostran ná patologie tlaku nad 100 m m Hg pod hrbolem sedací kosti (průměr 93 ± 21 m m Hg vlevo, průměr 103 ± 36 m m Hg vpravo). U sedmi byla oboustran ná patologie nad 100 m m Hg pod hrbolem sedací kosti (průměr 128 ± 19 m m Hg vlevo, 117 ± 21 m m Hg vpravo). Rozdíly byly ověřeny jako významné u tlaku pod hrbolem sedací kosti vlevo. Závěr: Ověřili jsme, že vyšetření pomocí PMS vhodně doplňuje komplexní posouzení pa cienta s mobilitou na vozíku.

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“…7,8 However, the incidence of PE after the initial 3 months post injury is poorly reported in literature. 9 In this study, over a 6-year period we examine the incidence rates of PE in SCI patients after anticoagulation was stopped.…”

Section: Introductionmentioning

confidence: 99%

Incidence of pulmonary embolism after the first 3 months of spinal cord injury

et al. 2015

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Background: Pulmonary embolism (PE) is a significant cause of morbidity and mortality in patients with spinal cord injury (SCI). Prophylactic anticoagulation is associated with a reduction in mortality rates, but there is limited evidence regarding the incidence rate of PE following cessation of anticoagulation after the first 3 months of injury. Study design: Single-centre retrospective study. Objective: To estimate the incidence rate of PE after 90 days of SCI. Setting: The National Spinal Injuries Centre at Stoke Mandeville Hospital, Aylesbury, UK. Methods: The study includes 640 new-onset SCI patients. All computer tomography pulmonary angiograms (CTPAs) or ventilationperfusion lung scans between 2008 and 2013 were identified. Medical notes and scans were reviewed and clinical outcomes and radiological findings were recorded. Results: A total of 91 patients with a new-onset SCI had a CTPA or a perfusion lung scan. PE was detected in a total of 8 patients. The incidence of PE was 1.25%; 95% confidence interval (0.39-2.11) over a 6-year period. The duration of injury at the time of PE was 7 months. Conclusion: The incidence rate of PE post 3 months of SCI remains significant, though much lower than immediately post injury.

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The prevalence of pulmonary embolism in chronically paralyzed subjects: a review of available evidence

Cited by 5 publications

References 36 publications

Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature

Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature

The Relevance of Pressure Mapping System in Wheelchair Mobility

Incidence of pulmonary embolism after the first 3 months of spinal cord injury

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The prevalence of pulmonary embolism in chronically paralyzed subjects: a review of available evidence

Cited by 5 publications

References 36 publications

Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature

Thromboembolism in the Sub-Acute Phase of Spinal Cord Injury: A Systematic Review of the Literature

The Relevance of Pres­sure Mapp­ing System in Wheelchair Mobility

Incidence of pulmonary embolism after the first 3 months of spinal cord injury

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The Relevance of Pressure Mapping System in Wheelchair Mobility