PMID- 29164026
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2192-5682 (Print)
IS  - 2192-5690 (Electronic)
IS  - 2192-5682 (Linking)
VI  - 7
IP  - 3 Suppl
DP  - 2017 Sep
TI  - A Clinical Practice Guideline for the Management of Patients With Acute Spinal 
      Cord Injury: Recommendations on the Type and Timing of Anticoagulant 
      Thromboprophylaxis.
PG  - 212S-220S
LID - 10.1177/2192568217702107 [doi]
AB  - INTRODUCTION: The objective of this study is to develop evidence-based guidelines 
      that recommend effective, safe and cost-effective thromboprophylaxis strategies 
      in patients with spinal cord injury (SCI). METHODS: A systematic review of the 
      literature was conducted to address key questions relating to thromboprophylaxis 
      in SCI. Based on GRADE (Grading of Recommendation, Assessment, Development and 
      Evaluation), a strong recommendation is worded as "we recommend," whereas a 
      weaker recommendation is indicated by "we suggest." RESULTS: Based on conclusions 
      from the systematic review and expert panel opinion, the following 
      recommendations were developed: (1) "We suggest that anticoagulant 
      thromboprophylaxis be offered routinely to reduce the risk of thromboembolic 
      events in the acute period after SCI;" (2) "We suggest that anticoagulant 
      thromboprophylaxis, consisting of either subcutaneous low-molecular-weight 
      heparin or fixed, low-dose unfractionated heparin (UFH) be offered to reduce the 
      risk of thromboembolic events in the acute period after SCI. Given the potential 
      for increased bleeding events with the use of adjusted-dose UFH, we suggest 
      against this option;" (3) "We suggest commencing anticoagulant thromboprophylaxis 
      within the first 72 hours after injury, if possible, in order to minimize the 
      risk of venous thromboembolic complications during the period of acute 
      hospitalization." CONCLUSIONS: These guidelines should be implemented into 
      clinical practice in patients with SCI to promote standardization of care, 
      decrease heterogeneity of management strategies and encourage clinicians to make 
      evidence-informed decisions.
FAU - Fehlings, Michael G
AU  - Fehlings MG
AD  - Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
AD  - University of Toronto, Toronto, Ontario, Canada.
FAU - Tetreault, Lindsay A
AU  - Tetreault LA
AD  - Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
AD  - School of Medicine, University College Cork, Cork, Ireland.
FAU - Aarabi, Bizhan
AU  - Aarabi B
AD  - University of Maryland School of Medicine, Baltimore, MD, USA.
FAU - Anderson, Paul
AU  - Anderson P
AD  - University of Wisconsin, Madison, WI, USA.
FAU - Arnold, Paul M
AU  - Arnold PM
AD  - The University of Kansas, Kansas City, KS, USA.
FAU - Brodke, Darrel S
AU  - Brodke DS
AD  - University of Utah, Salt Lake City, UT, USA.
FAU - Burns, Anthony S
AU  - Burns AS
AD  - Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, 
      Canada.
FAU - Chiba, Kazuhiro
AU  - Chiba K
AD  - National Defense Medical College, Saitama, Japan.
FAU - Dettori, Joseph R
AU  - Dettori JR
AD  - Spectrum Research, Inc, Tacoma, WA, USA.
FAU - Furlan, Julio C
AU  - Furlan JC
AD  - University of Toronto, Toronto, Ontario, Canada.
AD  - Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, 
      Canada.
FAU - Hawryluk, Gregory
AU  - Hawryluk G
AD  - University of Utah, Salt Lake City, UT, USA.
FAU - Holly, Langston T
AU  - Holly LT
AD  - University of California at Los Angeles, Los Angeles, CA, USA.
FAU - Howley, Susan
AU  - Howley S
AD  - Christopher & Dana Reeve Foundation, Short Hills, NJ, USA.
FAU - Jeji, Tara
AU  - Jeji T
AD  - Ontario Neurotrauma Foundation, Toronto, Ontario, Canada.
FAU - Kalsi-Ryan, Sukhvinder
AU  - Kalsi-Ryan S
AD  - Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
FAU - Kotter, Mark
AU  - Kotter M
AD  - University of Cambridge, Cambridge, UK.
FAU - Kurpad, Shekar
AU  - Kurpad S
AD  - Medical College of Wisconsin, Milwaukee, WI, USA.
FAU - Kwon, Brian K
AU  - Kwon BK
AD  - University of British Columbia, Vancouver, British Columbia, Canada.
FAU - Marino, Ralph J
AU  - Marino RJ
AD  - Thomas Jefferson University Hospital, Philadelphia, PA, USA.
FAU - Martin, Allan R
AU  - Martin AR
AD  - Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
FAU - Massicotte, Eric
AU  - Massicotte E
AD  - Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
FAU - Merli, Geno
AU  - Merli G
AD  - Sidney Kimmel Medical College, Thomas Jefferson University Hospitals, 
      Philadelphia, PA, USA.
FAU - Middleton, James W
AU  - Middleton JW
AD  - University of Sydney, Sydney, New South Wales, Australia.
FAU - Nakashima, Hiroaki
AU  - Nakashima H
AD  - Nagoya University Graduate School of Medicine, Nagoya, Japan.
FAU - Nagoshi, Narihito
AU  - Nagoshi N
AD  - Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
AD  - Keio University School of Medicine, Keio, Japan.
FAU - Palmieri, Katherine
AU  - Palmieri K
AD  - The University of Kansas, Kansas City, KS, USA.
FAU - Singh, Anoushka
AU  - Singh A
AD  - Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
FAU - Skelly, Andrea C
AU  - Skelly AC
AD  - Spectrum Research, Inc, Tacoma, WA, USA.
FAU - Tsai, Eve C
AU  - Tsai EC
AD  - University of Ottawa, Ottawa, Ontario, Canada.
FAU - Vaccaro, Alexander
AU  - Vaccaro A
AD  - Thomas Jefferson University, Philadelphia, PA, USA.
FAU - Wilson, Jefferson R
AU  - Wilson JR
AD  - University of Toronto, Toronto, Ontario, Canada.
AD  - Li Ka Shing Knowledge Institute, St. Michael s Hospital, Toronto, Ontario, 
      Canada.
FAU - Yee, Albert
AU  - Yee A
AD  - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
FAU - Harrop, James S
AU  - Harrop JS
AD  - Thomas Jefferson University, Philadelphia, PA, USA.
LA  - eng
PT  - Journal Article
DEP - 20170905
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC5684841
OTO - NOTNLM
OT  - acute spinal cord injury
OT  - anticoagulant
OT  - anticoagulant thromboprophylaxis
OT  - guideline
OT  - spinal cord injury
OT  - thromboprophylaxis
OT  - traumatic spinal cord injury
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2017/11/23 06:00
MHDA- 2017/11/23 06:01
PMCR- 2017/09/05
CRDT- 2017/11/23 06:00
PHST- 2017/11/23 06:00 [entrez]
PHST- 2017/11/23 06:00 [pubmed]
PHST- 2017/11/23 06:01 [medline]
PHST- 2017/09/05 00:00 [pmc-release]
AID - 10.1177_2192568217702107 [pii]
AID - 10.1177/2192568217702107 [doi]
PST - ppublish
SO  - Global Spine J. 2017 Sep;7(3 Suppl):212S-220S. doi: 10.1177/2192568217702107. 
      Epub 2017 Sep 5.