Journal of Yeungnam Medical Science

Original articles

Physical therapy, Sports Therapy, and Rehabilitation
Incidence and risk factors of deep vein thrombosis and pulmonary thromboembolism after spinal cord disease at a rehabilitation unit: a retrospective study: Yoonhee Kim, Minjae Jeong, Myung Woo Park, Hyun Iee Shin, Byung Chan Lee, Du Hwan Kim; J Yeungnam Med Sci. 2023;40(Suppl):S56-S64. Published online September 20, 2023; DOI: https://doi.org/10.12701/jyms.2023.00689

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Background
Deep vein thrombosis (DVT) and pulmonary thromboembolism (PTE) are major complications of spinal cord disease. However, studies of their incidence in Korean patients are limited. Thus, this study investigated the incidence and risk factors of DVT and PTE in Korean patients with spinal cord disease.
Methods
We retrospectively analyzed the medical records of 271 patients with spinal cord disease who were admitted to a rehabilitation unit within 3 months of disease onset at a tertiary hospital. The presence of DVT and PTE was mainly determined using Doppler ultrasonography and chest embolism computed tomography. Risk factor analysis included variables such as sex, age, obesity, completeness of motor paralysis, neurological level of injury, cause of injury, lower extremity fracture, active cancer, and functional ambulation category (FAC) score.
Results
The incidences of DVT and PTE in the patients with spinal cord disease were both 6.3%. Risk factor analysis revealed that age of ≥65 years (p=0.031) and FAC score of ≤1 (p=0.023) were significantly associated with DVT development. Traumatic cause of injury (p=0.028) and DVT (p<0.001) were significant risk factors of PTE.
Conclusion
Patients with spinal cord disease developed DVT and PTE within 3 months of disease onset with incidence rates of 6.3% and 6.3%, respectively. Age of ≥65 years and an FAC of score ≤1 were risk factors for DVT. Traumatic cause of injury and DVT were risk factors for PTE. However, given the inconsistent results of previous studies, the risk factors for DVT and PTE remain inconclusive. Therefore, early screening for DVT and PTE should be performed in patients with acute-to-subacute spinal cord disease regardless of the presence or absence of these risk factors.

Citations

Citations to this article as recorded by

Safety and efficacy of botulinum toxin in Human T-Lymphotropic Virus-1-Associated Myelopathy/Tropical Spastic Paraparesis: A randomized clinical trial
Matheus Sales, Giselle Barbara De Almeida Scaldafferri, Matheus Henrique Almeida, Vítor Melo, Tatiana Dias, Paulo Canas Rodrigues, Ailton Melo, Nildo Manoel Da Silva Ribeiro
The Journal of Spinal Cord Medicine.2026; : 1. CrossRef
Assessing the Incidence and Risk Factors of Deep Vein Thrombosis in Traumatic Spinal Cord Injury Patients at Tertiary Care Hospital in India
Sushil Chugh, Dhananjay B. Alagundagi, Shwetha Shetty Kalladka, Prakash Patil, Kurian Zachariah
Indian Journal of Physical Medicine and Rehabilitation.2025; 35(3): 191. CrossRef
Trends and Impact of Pharmacological VTE Prophylaxis Timing for Traumatic Cervical Spinal Cord Injury Across North American Trauma Centers
Ahmad Essa, Armaan K. Malhotra, Husain Shakil, James P. Byrne, Jetan Badhiwala, Avery B. Nathens, Tej D. Azad, Eva Y. Yuan, Yingshi He, Andrew S. Jack, Francois Mathieu, Jefferson R. Wilson, Christopher D. Witiw
Journal of Bone and Joint Surgery.2025;[Epub] CrossRef
Associations of RBC counts and incidence of DVT in patients with spinal cord injury: a five year observational retrospective study
Zhang Jinlong, Wang Cheng, He Chengqi
Journal of Orthopaedic Surgery and Research.2024;[Epub] CrossRef
Coagulation parameters correlate to venous thromboembolism occurrence during the perioperative period in patients with spinal fractures
Yong Jiao, Xiaohong Mu
Journal of Orthopaedic Surgery and Research.2023;[Epub] CrossRef

Cardiology and Cardiovascular Medicine
Perioperative outcomes of interrupted anticoagulation in patients with non-valvular atrial fibrillation undergoing non-cardiac surgery: Bo Eun Park, Myung Hwan Bae, Hyeon Jeong Kim, Yoon Jung Park, Hong Nyun Kim, Se Yong Jang, Jang Hoon Lee, Dong Heon Yang, Hun Sik Park, Yongkeun Cho, Shung Chull Chae; Yeungnam Univ J Med. 2020;37(4):321-328. Published online July 16, 2020; DOI: https://doi.org/10.12701/yujm.2020.00353

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Abstract PDF

Background
This study aimed to investigate the incidences of and risk factors for perioperative events following anticoagulant discontinuation in patients with non-valvular atrial fibrillation (NVAF) undergoing non-cardiac surgery.
Methods
A total of 216 consecutive patients who underwent cardiac consultation for suspending perioperative anticoagulants were enrolled. A perioperative event was defined as a composite of thromboembolism and major bleeding.
Results
The mean anticoagulant discontinuation duration was 5.7 (±4.2) days and was significantly longer in the warfarin group (p<0.001). Four perioperative thromboembolic (1.85%; three strokes and one systemic embolization) and three major bleeding events (1.39%) were observed. The high CHA2DS2-VASc and HAS-BLED scores and a prolonged preoperative anticoagulant discontinuation duration (4.4±2.1 vs. 2.9±1.8 days; p=0.028) were associated with perioperative events, whereas the anticoagulant type (non-vitamin K antagonist oral anticoagulants or warfarin) was not. The best cut-off levels of the HAS-BLED and CHA2DS2-VASc scores were 3.5 and 2.5, respectively, and the preoperative anticoagulant discontinuation duration for predicting perioperative events was 2.5 days. Significant differences in the perioperative event rates were observed among the four risk groups categorized according to the sum of these values: risk 0, 0%; risk 1, 0%; risk 2, 5.9%; and risk 3, 50.0% (p<0.001). Multivariate logistic regression analysis showed that the HAS-BLED score was an independent predictor for perioperative events.
Conclusion
Thromboembolic events and major bleeding are not uncommon during perioperative anticoagulant discontinuation in patients with NVAF, and interrupted anticoagulation strategies are needed to minimize these.

Citations

Citations to this article as recorded by

Evaluation of clinical outcome and predictive factors for thromboembolism or hemorrhagic complications in patients treated for chronic subdural hematoma. A prospective observational study
Alba Scerrati, Giorgio Mantovani, Michele Alessandro Cavallo, Maria Elena Flacco, Pietro Zangrossi, Silvia Eichner, Luca Ricciardi, Antonella Mangraviti, Antonino Raco, Tamara Ius, Daniele Piccolo, Oriela Rustemi, Fabio Raneri, Carmelo Lucio Sturiale, Alb
Neurosurgical Review.2025;[Epub] CrossRef
Clinical outcomes and hemorrhagic or thromboembolic risks in decompressive craniectomy for patients taking antiplatelet or anticoagulant therapy
Alba Scerrati, Giovanni Scanferla, Lorenzo Sgarbanti, Giorgio Mantovani, Chiara Angelini, Maria Elena Flacco, Rosario Maugeri, Lapo Bonosi, Domenico Gerardo Iacopino, Silvana Tumbiolo, Alessandro Adorno, Lara Brunasso, Giorgio Lofrese, Vittoria Rosetti, L
Neurosurgical Review.2025;[Epub] CrossRef
Development of a nomogram for prediction of postoperative bleeding after transurethral resection of bladder tumors
Paloma Pellegrino, Thomas Paul Scherer, Marian Severin Wettstein, Melanie Baumgartner, Daniel Eberli, Cédric Poyet, Uwe Bieri
International Urology and Nephrology.2025; 58(3): 921. CrossRef
Bleeding risk in female patients undergoing intravesical injection of onabotulinumtoxinA for overactive bladder: a Danish retrospective cohort study
Meryam El Issaoui, Sophia Elissaoui, Marlene Elmelund, Niels Klarskov
International Urogynecology Journal.2023; 34(10): 2581. CrossRef

Case Report

Cardiology and Cardiovascular Medicine
Acute upper limb ischemia in a patient with newly diagnosed paroxysmal atrial fibrillation: Dong Shin Kim, Seunghwan Kim, Hyang Ki Min, Chiwoo Song, Young Bin Kim, Sae Jong Kim, Ji Young Park, Sung Kee Ryu, Jae Woong Choi; Yeungnam Univ J Med. 2017;34(2):242-246. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.242

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Abstract PDF: Acute limb ischemia (ALI) due to an embolism is associated with high mortality rate and poor prognosis, and early diagnosis with prompt revascularization is required to reduce the risk of limb amputation or even death. The etiologies of ALI are diverse, and it includes an embolism from the heart and thrombotic occlusion of the atherosclerotic native vessels, stents, or grafts. An uncommon cause of ALI is acute arterial thromboembolism, and atrial fibrillation (AF) is the single most important risk factors for systemic thromboembolism. It is important to correctly identify the source of ALI for secondary prevention, as it depends on the underlying cause. Percutaneous transluminal angioplasty (PTA) has been proven to be a safe and effective treatment for focal atherosclerotic and thrombotic occlusive diseases of the aorta and its major extremity branches. Herein, we report on a 77-year-old female patient with acute upper limb ischemia, treated by PTA using a catheter-guided thrombectomy. He was newly diagnosed with paroxysmal AF (PAF) while evaluation the cause of his acute arterial thromboembolism. We recommend that cardiologists always consider PAF as a possible diagnosis even in patients without any history of AF under ALI because it is possible to develop thromboembolism in clinical practice.

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