Spinal Cord Injury Risk Assessment for Thromboembolism (SPIRATE Study)

David Green*, Diane Hartwig, David Chen, Robert C. Soltysik, Paul R. Yarnold

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

52 Scopus citations


Objective: To identify risk factors for venous thromboembolism (VTE) during the rehabilitation phase of spinal cord injury. Design: A comprehensive review of the charts of all patients admitted between 1992 and 1995 for rehabilitation after spinal cord injury. Only records including evidence for objective testing for thromboembolism were included. The analysis variables included type and location of spinal cord injury, American Spinal Injury Association classification, concomitant injuries, surgical procedures, complications, preexisting illnesses, and use of antithrombotic prophylaxis. Hierarchically optimal classification tree analysis was employed to develop a nonlinear model for predicting deep vein thrombosis. Results: The analysis sample consisted of these 243 persons with acute spinal cord injury, 51 of whom had venous thromboembolism, and eight of whom died. A three-variable model emerged that identified patient groups differing in relative likelihood of experiencing deep vein thrombosis. The highest likelihood group were patients with cancer over the age of 35 yrs. Women between the ages of 36 and 58 yrs without cancer were also at increased risk, as were cancer-free men with flaccid paralysis. Conclusions: Venous thromboembolism is more likely to develop in spinal cord injury patients who are older, obese, and have flaccid paralysis or cancer. These patients should receive vigorous prophylaxis against venous thromboembolism.

Original languageEnglish (US)
Pages (from-to)950-956
Number of pages7
JournalAmerican Journal of Physical Medicine and Rehabilitation
Issue number12
StatePublished - Dec 1 2003


  • Complications
  • Risk Factors
  • Spinal Cord Injury
  • Thromboembolism

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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