Prevalence and risk factors of deep venous thrombosis in patients with longitudinally extensive transverse myelitis: one center data from China

Tian Song,Yonghong Liu,Xinghu Zhang,Xindi Li

doi:10.1186/s12883-018-1178-1

Abstract

ObjectiveDeep venous thrombosis (DVT) is a severe complication in longitudinally extensive transverse myelitis (LETM) patients. It may interfere with LETM treatment and delay the recovery of the spinal dysfunction. However, there is less data about the prevalence and risk factors of DVT in patients with LETM. We analyzed data retrospectively to ascertain the prevalence of DVT and the clinical risk factors for DVT.MethodsClinical data on 255 LETM patients were collected from medical records. All patients were performed color Doppler ultrasound(US) to screen DVT in both lower extremities when admitted. Clinical characteristics of LETM patients with DVT were compared with those without DVT using corresponding statistical methods. Multivariate logistic regression was performed to identify risk factors related to DVT.ResultsDVT were found in 11.8% patients with LETM. Univariate analysis showed that age, muscle force and elevated baseline D-dimer were risk factors for DVT. After multivariate logistic regression, age, dyslipidemia, segments of lesions, and elevated baseline D-dimer remained significant independent risk factors.ConclusionsDVT is common in patients with LETM and related to patient’s age, dyslipidemia, segments of lesions, and elevated baseline D-dimer. Early recognition of DVT and thrombosis prophylaxis are appropriate in patients with LETM.

Highlights

Extensive transverse myelitis (LETM) is defined as myelitis with lesion extending at least 3 continuous vertebral segments in length [1]
deep venous thrombosis (DVT) were found in 11.8% patients with Longitudinally extensive transverse myelitis (LETM)
Univariate analysis showed that age, muscle force and elevated baseline D-dimer were risk factors for DVT

Summary

Introduction

Extensive transverse myelitis (LETM) is defined as myelitis with lesion extending at least 3 continuous vertebral segments in length [1]. A number of conditions can be associated with LETM, including neuromyelitis optica spectrum disorder (NMOSD), spinal infarction, spinal dural arteriovenous fistulas, compressive lesions, metabolic disorders, neoplasm, infection [2]. NMOSD is VTE includes deep venous thrombosis (DVT) and pulmonary embolism (PE). VTE affects 1/1000 patients, costs $13.5 billion annually to treat, and claims 100,000 lives annually in the US [6]. The risk of VTE in individuals with LETM may has been underestimated despite several plausible mechanisms. Autoimmune disorder associated with LETM may upregulate procoagulants, Song et al BMC Neurology (2018) 18:179 downregulate anticoagulants and suppress fibrinolysis [7]

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Conclusion