AA

Summary

There is level 2 evidence (from one RCT; Agarwal and Mathur 2009) that low-dose unfractionated heparin is not effective as prophylaxis for venous thromboembolism in acute SCI individuals; However, there is level 4 evidence (from one case series; Winemiller et al. 1999) that low-dose unfractionated heparin is effective as prophylaxis for venous thromboembolism if provided early (within 14 days after injury).

There is level 1b evidence (from one RCT and one case control; Chiou-Tan et al. 2003; Slavik et al. 2007) that 30 mg twice daily Enoxaparin and 5000 IU daily Dalteparin are equally effective as prophylaxis for venous thromboembolism in acute SCI individuals. 

There is level 4 evidence (from one case control; Hebbeler et al. 2004) that twice daily 30 mg Enoxaparin is equally as effective as 40 mg daily Enoxaparin as prophylaxis for venous thromboembolism in acute SCI individuals.

There is level 1b evidence (from one RCT; Green et al. 1990) that Logiparin is more effective than low-dose unfractionated heparin as prophylaxis for venous thromboembolism in acute SCI individuals. 

There is level 1b evidence (from one RCT; Spinal Cord Injury Thromboprophylaxis Investigators 2003a) that Enoxaparin is more effective than low-dose unfractionated heparin as prophylaxis for pulmonary emboli in acute SCI individuals, but equally as effective for deep venous thrombosis in acute SCI individuals; However, there is level 2 evidence (from one prospective controlled trial and two case controls; Spinal Cord Injury Thromboprophylaxis Investigators 2003b; Arnold et al. 2010; Thumbikat et al. 2002) that Enoxaparin is equally as effective as low-dose unfractionated heparin as prophylaxis for venous thromboembolism in acute SCI individuals. 

There is level 3 evidence (from one case control; Worley et al. 2008) that Dalteparin is equally as effective as low-dose unfractionated heparin as prophylaxis for venous thromboembolism in acute SCI individuals. 

There is level 4 evidence (from one pre-post and two case series; Chung et al. 2011; Maxwell et al. 2002; Winemiller et al. 1999) that sequential compression or gradient elastic stockings are associated with a reduced the risk of venous thromboembolism in acute SCI individuals.

There is level 1b evidence (from one RCT; Spinal Cord Injury Thromboprophylaxis Investigators 2003a) that low-dose unfractionated heparin in combination with intermittent pneumatic compressionis as effective as Enoxaparin as prophylaxis for deep vein thrombosis in acute SCI individuals.

There is level 3 evidence (from one case control; Merli et al. 1992) that pneumatic compression in combination with gradient elastic stockings and low-dose unfractionated heparin is effective in reducing the incidence of deep vein thrombosis in acute SCI individuals.

There is level 1b evidence (from one RCT; Halim et al. 2014) that Enoxaparin in combination with physical measures is more effective than physical measures alone as prophylaxis for deep venous thrombosis in acute SCI individuals; However, there is level 4 evidence (from one case series; Maxwell et al. 2002) that Enoxaparin plus sequential compression devices, low-dose unfractionated heparin plus sequential compression devices, and sequential compression devices alone are similarly effective as venous thromboembolism prophylaxis in acute SCI individuals.  

There is level 3 evidence (from two case controls; Gorman et al. 2009; Kinney et al. 1996) that inferior vena cava filter placement does not prevent occurrences of venous thromboembolism in acute SCI individuals; However, there is level 4 evidence (from two pre-posts and one case series; Roberts and Young 2010; Rogers et al. 1995; Wilson et al. 1994) that inferior vena cava filter placement is effective in the prevention of pulmonary embolism in acute SCI individuals.