Q: Prophylaxis to prevent deep venous thrombosis and pulmonary embolism - VTE - should be continued for at least how long after spinal cord injuries (SCI)?
A) Two weeks
B) Four weeks
C) Three months
D) Six months
E) Indefinite
Answer: C
In patients with acute SCI, after considering all risks and benefits, usual recommended duration for VTE prophylaxis is about three months. Ideally, pharmacologic intervention with low molecular weight heparin (LMWH) is recommended but warfarin with Internationalized Normalized Ratio (INR) of 2 to 3 is also acceptable.
#trauma
References:
1. Paralyzed Veterans of America. Consortium for Spinal Cord Medicine. Prevention of Thromboembolism in individuals with Spinal Cord Injury. Clinical practice guideline for healthcare providers. 3rd Edition. 2016.
2. Ploumis A, Ponnappan RK, Maltenfort MG, et al. Thromboprophylaxis in patients with acute spinal injuries: an evidence-based analysis. J Bone Joint Surg Am 2009; 91:2568.
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