Venous Thromboembolism Table 13 Prophylactic Vena Cava Insertion in Patients with Traumatic SCI

Author Year
Country
PEDro Score
Research Design
Sample Size

Methods

Outcomes

Roberts et al. 2011
USA
Case Series
N=45

Population: Mean age: 39.7 yr (17-67); Gender: males=37, females=8; Injury severity: Injury Severity Score: 34.2; Chronicity: acute (<72 hr post SCI).
Intervention: Prophylactic IVC filter insertion.
Outcome Measures: Incidence of pulmonary embolism (PE) and complications related to insertion
  1. Not one patient sustained a PE.
  2. No complications related to IVCF insertion were observed.

Gorman et al. 2009
USA
Case Control
N=114

Population: IVC filter (N=54): Mean age=37.1yr; Gender: males=52%, females=48%; Level of injury: tetraplegic=38.8%; No IVC filter (N=58): Mean age=48.1yr; Gender: males=40%, females=60%; Level of injury: tetraplegic=51.7%
InterventionCharts were reviewed of SCI patients admitted to rehabilitation who had or had not received a prophylactic IVC filter.
Outcome Measures: Incidence of deep venous thrombosis (DVT).
  1. IVC filters were more likely to be inserted in individuals with major trauma than those without.
  2.  Patients without IVC filter had fewer DVTs than those with an IVC filter (5.2% vs. 20.4%, p=0.021).
  3. Incidence of DVT was not related to AIS score although individuals with an Injury Severity Score >30 were more likely to have DVT (p=0.007) and more likely to have received an IVC filter (p<0.001).

Kinney et al. 1996
USA
Case Control
N=27

Population: Cervical (n=11): Mean age=38.8yr; Control (non-cervical, n=16): Mean age=48.6yr; Gender: males=62%, females=38%
Intervention: Charts of SCI patients who received prophylactic Greenfield filter insertion were reviewed and compared to non-SCI patients who received the filter.
Outcome Measures: Complications.
  1. The most common complication (45.5%) in cervical patients with filter insertions was migration.
  2. The mean migration distance was significantly higher in cervical patients than non-cervical patients (13.3 mm vs. 2.3 mm; p<0.05).
  3. The SCI population had higher rates of PE (9-18%) than the non-SCI control group..

Wilson et al. 1994
USA
Pre-Post
N=15

Population: Age = 18-49 yr; Severity of injury: Injury Severity Score=25-41; Chronicity=acute.
Intervention: Prophylactic IVC filter insertion.
Outcome Measures: Incidence of deep venous thrombosis (DVT/PE).
  1. No patient developed DVT during acute hospitalization (median 22 days), and no patient developed PE after filter insertion.

Balshi et al. 1989
USA
Case Series
N=13

Population: Age range=17-48 yr; Gender: males=11, females=2; Severity of Injury: quadriplegia.
Intervention: Prophylactic Greenfield inferior vena cava (IVC) filter insertion.
Outcome Measures: Incidence of deep venous thrombosis/pulmonary embolism (DVT/PE).
  1. Twelve patients experienced a DVT while one had a PE.
  2. Two patients experienced recurrent DVT.
  3. Distal migration of the filter occurred in two patients.

Jarrell et al. 1983
USA
Case Series
N=21

Population: Chronicity=acute.
Intervention: Prophylactic Greenfield inferior vena cava (IVC) filter insertion.
Outcome Measures: Incidence of pulmonary embolism (PE).
  1. There was one PE-related fatality.
  2. There was no other instance of suspected or proved PE after insertion of the filter.
  3. Follow-up revealed two instances of thrombosis.
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