DVT in SCI

1. What are predisposing factors to DVT?
2. When are DVTs most commonly seen in the SCI?
3. What are methods of DVT diagnosis?
4. How can DVT be prevented in the SCI population?
5. How is DVT treated?

Answers:
1. Virchow's triad (venous stasis, intimal injury, hypercoag), LE fx, obesity, previous DVT, DM, arterial vascular disease, immobility, malignancy.
2. Most common in first 2 weeks and incidence decreases 8-12 weeks post injury.
3. Venogram is the gold standard, dopplers are used for screening.
4. SCDs (do duplex if delayed >72 hrs), LMWH, TEDS, coumadin, unfractionated heparin, IVC filter.
5. Heparin drip or Lovenox 1mg/kg sq bid until coumadin therapeutic. Give 3 months of coumadin for DVT, 3-6 months for PE. No ROM in involved extremity. IVC filter if no anticoagulation.