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

Abstract

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. Single-centre retrospective study. To estimate the incidence rate of PE after 90 days of SCI. The National Spinal Injuries Centre at Stoke Mandeville Hospital, Aylesbury, UK. 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. 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. The incidence rate of PE post 3 months of SCI remains significant, though much lower than immediately post injury.