Le 14/10/2021 de 16:30 à 18:00
Incidence de la thrombose veineuse profonde entre 3 et 12 mois après une lésion de la moelle épinière: une étude prospective monocentrique.
Marc Le Fort (Nantes, France), Olivier Espitia (Nantes, France), Bénédicte Reiss (Nantes, France), Chloé Lefevre (Nantes, France), Brigitte Perrouin-Verbe (Nantes, France)
Objective : Venous thromboembolism (VTE) is a major issue after a spinal cord injury (SCI), with a prevalence of 47 to 80% against 10 to 20% in the general population. The risk of deep vein thrombosis (DVT) would decrease after the first weeks with a prevalence slightly higher than the general population after 12 weeks. There is no prospective DVT incidence study in SCI after 3 months. We aimed to calculate the incidence of DVT during the first year after SCI and to define the associated risk factors.
Material / Patients and Methods : We performed doppler ultrasonography at 6, 9 and 12 months after the occurrence of SCI, associated with clinical data (age, gender, body mass index, neurological assessment, WISCI, 10 MWT, spasticity, standing time, compression stockings, joints stiffness, muscles contractions, infection, time in wheelchair). Inclusion criteria were post-trauma or medical paraplegia or tetraplegia, NLI: C2-L5, age>18, stable respiratory status with absence of chronic hypoxemia.
Results : 82 patients were included, 67% men, mean age of 48 years and mean BMI = 23.5 kg/m2. The incidence of DVT occurrence between 3 and 12 months after SCI was 13.4% [7.6-22.4]. The multivariate analysis with selection of the variables from the univariate analysis with p-value < 0.20 and construction with the 'stepwise' method showed as significant risk and protective factors: age (+1 year, HR = 1.8, p<0.01) and walk (last status before diagnosis, HR = 0.02, p<0.01).
Discussion - Conclusion : Our results may enhance recommendations for longer preventive management of VTE after an SCI.
Keywords : spinal cord injury - venous thromboembolism - deep vein thrombosis - incidence - risk factors -
Disclosure of interest : None