Venous Thromboembolism and Pressure Ulcers in Acute Spinal Cord Injury: A Retrospective Review

Patients with acute spinal cord injury (SCI) are at high risk of development of complications such as venous thromboembolism (VTE) and pressure ulcers. Clinical guidelines recommend certain preventative and prophylactic strategies in order to reduce the risk of such complications. We aimed to assess the incidence of VTE and pressure ulcers in patients with SCI presenting to a level I trauma center and to evaluate potential factors that might be associated with their occurrence. Utilizing a prospective centralized trauma database, we identified 94 patients with acute SCI; of these 33% had completed SCI (American Spinal Injury Association Impairment Scale (AIS) grade A). VTE occurred at a rate of 11.7% with all affected patients being in the surgical group. Low Molecular Weight Heparin (LMWH) was administered in 72.1% of patients, with 26.9% of these patients developing VTE compared to 75% of patients treated with un fractionated heparin (UFH) (X2=3.6, P = 0.058). The incidence of pressure was 16.0%, with 30% of complete cord injuries being affected (P = 0.022). Development of pressure ulcers was associated with a delayed transfer to neurorehabilitation (P = 0.037). This study illustrates the experience of a level I trauma center in relation to development of specific SCI-related complications and emphasizes the role of certain parameters in reducing the rate of these complications.