Impact of coagulation in the development of thromboembolic events in patients with spinal cord injury

Abstract

Study design: Although the knowledge described about risk factors and venous thromboembolism (VT) in the general population, the impact of these factors in the development of thromboembolic events in patients with spinal injury (SI) caused by spinal cord injury (SCI) is poorly understood. Objective: Evaluate the impact of risk factors in the development of thromboembolic events in patients with SCI. Setting: Brazil, Sao Paulo. Methods: Observational, prospective and cross-study. Eligible patients (n = 100) had SI by SCI, > 18 years. The degree of motor and sensory lesion was evaluated based on American Spinal Injury Association (ASIA) Impairment Scale (AIS). Blood samples were collected for coagulation exams, hemogram, laboratory and biochemical analyses. Ultrasonography analyzes were performed from deep and superficial venous systems of lower limbs. Quantitative real-time PCR experiments were performed in order to investigate mutations in the prothrombin (G20210A) and Leiden factor V (G1691A) genes. Results: The main finding of this study was the higher occurrence of deep venous thrombosis (DVT) in patients with Leiden factor V and hyperhomocysteinemia. There was no association between SI for DVT, VT and thrombophilia. Also, there was no relation between lupus anticoagulant and anti-cardiolipin. Conclusion: There is an important difference in the incidence of DVT in patients with SI by acute and chronic SCI. Therefore, the conduct of the investigation for thrombophilia should be based on clinical factors, risk factors for DVT and family history of thrombosis.