Incidence and risk factors of deep vein thrombosis in patients with spinal cord injury: a systematic review with meta-analysis.

Zhizhong Shang, Pingping Wanyan, Baolin Zhang, Mingchuan Wang, Xin Wang
Author Information
  1. Zhizhong Shang: The First Clinical Medical College of Lanzhou University, Lanzhou, China.
  2. Pingping Wanyan: Department of Pathology and Pathophysiology, Gansu University of Chinese Medicine, Lanzhou, China.
  3. Baolin Zhang: The First Clinical Medical College of Lanzhou University, Lanzhou, China.
  4. Mingchuan Wang: The First Clinical Medical College of Lanzhou University, Lanzhou, China.
  5. Xin Wang: The First Clinical Medical College of Lanzhou University, Lanzhou, China.

Abstract

Background: Spinal cord injury (SCI) is a highly disabling disease with huge public health burden. The complications associated with it, especially deep vein thrombosis (DVT), further aggravate the disability.
Objective: To explore the incidence and risk factors of DVT after SCI, in order to provide guidance for disease prevention in the future.
Methods: A search was performed on PubMed, Web of Science, Embase, and Cochrane database up to November 9, 2022. Literature screening, information extraction and quality evaluation were performed by two researchers. The data was later combined by metaprop and metan commands in STATA 16.0.
Results: A total of 101 articles were included, including 223,221 patients. Meta-analysis showed that the overall incidence of DVT was 9.3% (95% CI: 8.2%-10.6%), and the incidence of DVT in patients with acute and chronic SCI was 10.9% (95% CI: 8.7%-13.2%) and 5.3% (95% CI: 2.2%-9.7%), respectively. The incidence of DVT decreased gradually with the accumulation of publication years and sample size. However, the annual incidence of DVT has increased since 2017. There are 24 kinds of risk factors that may contribute to the formation of DVT, involving multiple aspects of the baseline characteristics of the patient, biochemical indicators, severity of SCI, and comorbidities.
Conclusions: The incidence of DVT after SCI is high and has been gradually increasing in recent years. Moreover, there are numerous risk factors associated with DVT. Comprehensive preventive measures need to be taken as early as possible in the future.
Systematic Review Registration: www.crd.york.ac.uk/prospero, identifier CRD42022377466.

Keywords

References

  1. J Thromb Haemost. 2015 Oct;13(10):1823-32 [PMID: 26270389]
  2. Nat Rev Cardiol. 2023 Apr;20(4):248-262 [PMID: 36258120]
  3. Spinal Cord. 2021 Jul;59(7):804-813 [PMID: 33268825]
  4. World Neurosurg. 2018 Jan;109:e510-e516 [PMID: 29033376]
  5. J Thromb Thrombolysis. 2011 Feb;31(2):165-72 [PMID: 20640482]
  6. Nat Rev Dis Primers. 2017 Apr 27;3:17018 [PMID: 28447605]
  7. Proc Natl Acad Sci U S A. 1997 Aug 5;94(16):8779-82 [PMID: 9238054]
  8. J Neurotrauma. 2011 Aug;28(8):1509-14 [PMID: 20795870]
  9. Chin J Traumatol. 2017 Apr;20(2):118-121 [PMID: 28330804]
  10. Spinal Cord. 2015 Nov;53(11):835-7 [PMID: 26099210]
  11. Thromb Res. 2014 Apr;133(4):579-84 [PMID: 24457145]
  12. Blood Adv. 2020 Oct 13;4(19):4693-4738 [PMID: 33007077]
  13. Nat Rev Nephrol. 2018 May;14(5):337-351 [PMID: 29578207]
  14. JAMA. 2015 Jun 9;313(22):2236-43 [PMID: 26057284]
  15. J Trauma Acute Care Surg. 2018 Aug;85(2):387-392 [PMID: 29613956]
  16. Curr Opin Hematol. 2018 Sep;25(5):358-364 [PMID: 29994896]
  17. Am Surg. 2007 Dec;73(12):1228-31 [PMID: 18186377]
  18. Paraplegia. 1994 Dec;32(12):810-6 [PMID: 7708421]
  19. Spinal Cord. 2008 Jul;46(7):523-6 [PMID: 18227850]
  20. Dev Med Child Neurol. 2012 Dec;54(12):1138-43 [PMID: 22998495]
  21. Proc Natl Acad Sci U S A. 1996 Jan 9;93(1):245-9 [PMID: 8552614]
  22. Nat Rev Dis Primers. 2018 May 17;4:18028 [PMID: 29770793]
  23. ANZ J Surg. 2003 Sep;73(9):712-6 [PMID: 12956787]
  24. Spine (Phila Pa 1976). 2007 Aug 1;32(17):1908-16 [PMID: 17762301]
  25. Crit Care Med. 2010 Feb;38(2 Suppl):S3-9 [PMID: 20083911]
  26. J Thromb Haemost. 2012 Nov;10(11):2264-9 [PMID: 22906051]
  27. J Thromb Haemost. 2011 Jan;9(1):85-91 [PMID: 20942850]
  28. Eur Heart J. 2000 Jun;21(12):967-74 [PMID: 10901508]
  29. Int J Cardiol. 2004 Apr;94(2-3):293-300 [PMID: 15093996]
  30. Lancet Neurol. 2019 Jan;18(1):56-87 [PMID: 30497965]
  31. Spinal Cord. 2014 Feb;52(2):110-6 [PMID: 23439068]
  32. Arch Phys Med Rehabil. 2009 Feb;90(2):232-45 [PMID: 19236977]
  33. J Trauma Acute Care Surg. 2017 Dec;83(6):1088-1094 [PMID: 28863085]
  34. Injury. 2010 Jan;41(1):97-101 [PMID: 19608183]
  35. J Spinal Cord Med. 2016 Jul;39(4):400-4 [PMID: 26132450]
  36. Circulation. 2003 Jun 17;107(23 Suppl 1):I9-16 [PMID: 12814980]
  37. J Clin Neurosci. 2017 Nov;45:60-66 [PMID: 28890040]
  38. J Thromb Haemost. 2017 Feb;15(2):304-311 [PMID: 27930853]
  39. J Vasc Surg Venous Lymphat Disord. 2021 Nov;9(6):1391-1398.e3 [PMID: 33753301]
  40. Eur Heart J. 2008 Sep;29(18):2276-315 [PMID: 18757870]
  41. Int J Mol Sci. 2020 Oct 13;21(20): [PMID: 33066029]
  42. J Appl Physiol (1985). 1993 Nov;75(5):2079-83 [PMID: 8307862]
  43. Spine J. 2009 Jul;9(7):530-6 [PMID: 19251486]
  44. J Immunol. 2000 Sep 15;165(6):3411-7 [PMID: 10975860]
  45. Br J Haematol. 2002 Dec;119(4):1011-6 [PMID: 12472582]
  46. Arch Phys Med Rehabil. 2011 Oct;92(10):1534-41 [PMID: 21963121]
  47. Arch Phys Med Rehabil. 1999 Sep;80(9):1044-6 [PMID: 10489006]
  48. Front Cell Neurosci. 2019 Jun 06;13:248 [PMID: 31244609]
  49. Thromb Haemost. 2000 Apr;83(4):536-9 [PMID: 10780312]

Word Cloud

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