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Editorial
Authors:Inder Perkash
Institution:1. Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.;2. Department of Rehabilitation Medicine, University of Washington, Seattle, WA.;3. Department of Neurosurgery, Medical College of Wisconsin, Chief, Spinal Cord Injury Center, Veterans Affairs Medical Center, Milwaukee, WI.
Abstract:ABSTRACT

To determine the incidence of symptomatic thromboembolism in patients with chronic spinal cord injury, a retrospective review of patients followed in a Veteran's Affairs Spinal Cord Injury Unit was conducted. Followed for a mean of 13.7 years after injury, 287 patients were reviewed. Forty events were identified, an incidence of 10 percent. Thirty-three (83 percent) occurred in the first 6 months following injury. The remainder occurred at 1, 1.5, 7, 9, 10, 12, and 14 years after injury, an incidence of 0.17 percent per year.

The incidence of clinically significant thromboembolism in spinal cord injury decreases dramatically after the first 6 months to a level similar to that in the general population (0.18 percent). Possible explanations for this include: 1) immobilization by itself may not be a risk factor for thromboembolism; 2) physiologic adaptations in the chronic state may protect against thromboembolism; and, 3) thromboembolism occurs, but remains subclinical in most patients.
Keywords:thromboembolism  spinal cord injury  long-standing paralysis
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