Article

OBJECTIVE: To review systematically the published literature on the treatment of
deep venous thromboembolism after spinal cord injury (SCI).
DATA SOURCES : MEDLINE/PubMed, CINAHL, EMBASE, and PsycINFO databases were searched for articles
addressing the treatment of deep venous thromboembolism post-SCI. Randomized
controlled trials (RCTs) were assessed for methodologic quality using the
Physiotherapy Evidence Database Scale, while non-RCTs were assessed using the
Downs and Black evaluation tool. STUDY SELECTION: Studies included RCTs,
non-RCTS, cohort, case-control, case series, pre-post, and postinterventional
studies. Case studies were included only when no other studies were available.
DATA EXTRACTION: Data extracted included demographics, the nature of the study
intervention, and study results. DATA SYNTHESIS: Levels of evidence were assigned
to the interventions using a modified Sackett scale.
CONCLUSIONS: Twenty-three
studies met inclusion criteria. Thirteen studies examined various pharmacologic
interventions for the treatment or prevention of deep venous thrombosis in
patients with SCI. There was strong evidence to support the use of
low-molecular-weight heparin in reducing venous thrombosis events, and a higher
adjusted dose of unfractionated heparin was found to be more effective than 5000
units administered every 12 hours, although bleeding complications were more
common. Nonpharmacologic treatments were also reviewed, but again limited
evidence was found to support these treatments.

Langue : ANGLAIS