Incidence and risk factors of deep vein thrombosis in patients with spinal cord injury: a systematic review with meta-analysis

Zhizhong Shang; Pingping Wanyan; Baolin Zhang; Mingchuan Wang; Xin Wang

doi:10.3389/fcvm.2023.1153432

Incidence and risk factors of deep vein thrombosis in patients with spinal cord injury: a systematic review with meta-analysis

Front Cardiovasc Med. 2023 May 12:10:1153432. doi: 10.3389/fcvm.2023.1153432. eCollection 2023.

Authors

Zhizhong Shang¹, Pingping Wanyan^{2

3}, Baolin Zhang¹, Mingchuan Wang¹, Xin Wang^{1

4

5}

Affiliations

¹ The First Clinical Medical College of Lanzhou University, Lanzhou, China.
² Department of Pathology and Pathophysiology, Gansu University of Chinese Medicine, Lanzhou, China.
³ Department of Nephrology, The Second Hospital of Lanzhou University, Lanzhou, China.
⁴ Chengren Institute of Traditional Chinese Medicine, Lanzhou, China.
⁵ Department of Spine, Changzheng Hospital, Naval Medical University, Shanghai, China.

Abstract

Background: Spinal cord injury (SCI) is a highly disabling disease with huge public health burden. The complications associated with it, especially deep vein thrombosis (DVT), further aggravate the disability.

Objective: To explore the incidence and risk factors of DVT after SCI, in order to provide guidance for disease prevention in the future.

Methods: A search was performed on PubMed, Web of Science, Embase, and Cochrane database up to November 9, 2022. Literature screening, information extraction and quality evaluation were performed by two researchers. The data was later combined by metaprop and metan commands in STATA 16.0.

Results: A total of 101 articles were included, including 223,221 patients. Meta-analysis showed that the overall incidence of DVT was 9.3% (95% CI: 8.2%-10.6%), and the incidence of DVT in patients with acute and chronic SCI was 10.9% (95% CI: 8.7%-13.2%) and 5.3% (95% CI: 2.2%-9.7%), respectively. The incidence of DVT decreased gradually with the accumulation of publication years and sample size. However, the annual incidence of DVT has increased since 2017. There are 24 kinds of risk factors that may contribute to the formation of DVT, involving multiple aspects of the baseline characteristics of the patient, biochemical indicators, severity of SCI, and comorbidities.

Conclusions: The incidence of DVT after SCI is high and has been gradually increasing in recent years. Moreover, there are numerous risk factors associated with DVT. Comprehensive preventive measures need to be taken as early as possible in the future.

Systematic review registration: www.crd.york.ac.uk/prospero, identifier CRD42022377466.

Keywords: deep vein thrombosis; incidence; risk factor; spinal cord injury; systematic review.

Publication types

Review

Grants and funding

We acknowledge the financial support from Gansu Natural Science Foundation (grant no. 21JR7RA362), Gansu Youth Doctoral Fund Project of Colleges and Universities (grant no. 2022QB-007), and The First Hospital of Lanzhou University Foundation (grant no. ldyyyn2021-121).