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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2010-5-31
pubmed:abstractText
Venous thromboembolism (VTE) is a well-recognized complication of Acute Traumatic Spinal Cord Injury (ATSCI). Despite prophylaxis by heparins, VTE occurs in a substantial number of ATSCI patients without an obvious explanation. In this matched case-control study we examined whether thrombophilia and other risk factors are associated with failure of thromboprophylaxis. Cases and controls receiving heparin thromboprophylaxis were selected from consecutively admitted ATSCI patients. Patients who developed a new, objectively confirmed, symptomatic VTE despite prophylaxis at hospital were matched by gender, age, level and mechanism of ATSCI with 2-3 controls without VTE. Patients were interviewed about VTE risk factors and tested for factor V Leiden (FVL), prothrombin G20210A (PT), methylenetetrahydrofolate reductase C677T homozygosity (MTHFR), lupus anticoagulant, homocysteine (Hcy) and plasma factor VIII (FVIII) levels. Twenty-two patients with new VTE episodes and 64 controls were ascertained. The total number of gene alterations for MTHFR, FVL and PT or elevated levels of Hcy or FVIII was significantly more common in patients compared to controls (82% vs. 48%, p=0.006). Multiple logistic regression proved the PT mutation, a positive family history of thrombosis and elevated levels of either FVIII or Hcy to be predictors of thrombosis. CONCLUSION: A positive family history of VTE, carriership of the prothrombin mutation and elevated FVIII or Hcy levels were significantly associated with failure to prevent VTE by heparin therapy following ATSCI. Testing for thrombophilia in patients with ATSCI and possibly a more intense thromboprophylactic regimen seem desirable but need to be verified by a prospective study.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1879-2472
pubmed:author
pubmed:copyrightInfo
Copyright 2009 Elsevier Ltd. All rights reserved.
pubmed:issnType
Electronic
pubmed:volume
125
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
501-4
pubmed:meshHeading
pubmed-meshheading:19853891-Adolescent, pubmed-meshheading:19853891-Adult, pubmed-meshheading:19853891-Case-Control Studies, pubmed-meshheading:19853891-Child, pubmed-meshheading:19853891-Disease Susceptibility, pubmed-meshheading:19853891-Female, pubmed-meshheading:19853891-Heparin, pubmed-meshheading:19853891-Humans, pubmed-meshheading:19853891-Logistic Models, pubmed-meshheading:19853891-Male, pubmed-meshheading:19853891-Middle Aged, pubmed-meshheading:19853891-Predictive Value of Tests, pubmed-meshheading:19853891-Premedication, pubmed-meshheading:19853891-Risk Factors, pubmed-meshheading:19853891-Spinal Cord Injuries, pubmed-meshheading:19853891-Thrombophilia, pubmed-meshheading:19853891-Thrombosis, pubmed-meshheading:19853891-Trauma, Nervous System, pubmed-meshheading:19853891-Treatment Failure, pubmed-meshheading:19853891-Young Adult
pubmed:year
2010
pubmed:articleTitle
Risk factors for failure of heparin thromboprophylaxis in patients with acute traumatic spinal cord injury.
pubmed:affiliation
Department of Neurological Rehabilitation, the Chaim Sheba Medical Center, Tel-Hashomer, and Sackler Faculty of Medicine, Tel-Aviv University, Israel.
pubmed:publicationType
Journal Article