Incidence of pulmonary embolism after the first 3 months of spinal cord injury

Abstract

Background:Pulmonary embolism (PE) is a significant cause of morbidity and mortality in patients with spinal cord injury (SCI). Prophylactic anticoagulation is associated with a reduction in mortality rates, but there is limited evidence regarding the incidence rate of PE following cessation of anticoagulation after the first 3 months of injury.Study design:Single-centre retrospective study.Objective:To estimate the incidence rate of PE after 90 days of SCI.Setting:The National Spinal Injuries Centre at Stoke Mandeville Hospital, Aylesbury, UK.Methods:The study includes 640 new-onset SCI patients. All computer tomography pulmonary angiograms (CTPAs) or ventilation-perfusion lung scans between 2008 and 2013 were identified. Medical notes and scans were reviewed and clinical outcomes and radiological findings were recorded.Results:A total of 91 patients with a new-onset SCI had a CTPA or a perfusion lung scan. PE was detected in a total of 8 patients. The incidence of PE was 1.25%; 95% confidence interval (0.39-2.11) over a 6-year period. The duration of injury at the time of PE was 7 months.Conclusion:The incidence rate of PE post 3 months of SCI remains significant, though much lower than immediately post injury.