A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the type and timing of anticoagulant thromboprophylaxis

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dc.contributor.author Fehlings, Michael G.
dc.contributor.author Tetreault, Lindsay A.
dc.contributor.author Aarabi, Bizhan
dc.contributor.author Anderson, Paul
dc.contributor.author Arnold, Paul M.
dc.contributor.author Brodke, Darrel S.
dc.contributor.author Burns, Anthony S.
dc.contributor.author Chiba, Kazuhiro
dc.contributor.author Dettori, Joseph R.
dc.contributor.author Furlan, Julio C.
dc.contributor.author Hawryluk, Gregory
dc.contributor.author Holly, Langston T.
dc.contributor.author Howley, Susan
dc.contributor.author Jeji, Tara
dc.contributor.author Kalsi-Ryan, Sukhvinder
dc.contributor.author Kotter, Mark
dc.contributor.author Kurpad, Shekar
dc.contributor.author Kwon, Brian K.
dc.contributor.author Marino, Ralph J.
dc.contributor.author Martin, Allan R.
dc.contributor.author Massicotte, Eric
dc.contributor.author Merli, Geno
dc.contributor.author Middleton, James W.
dc.contributor.author Nakashima, Hiroaki
dc.contributor.author Nagoshi, Narihito
dc.contributor.author Palmieri, Katherine
dc.contributor.author Singh, Anoushka
dc.contributor.author Skelly, Andrea C.
dc.contributor.author Tsai, Eve C.
dc.contributor.author Vaccaro, Alexander
dc.contributor.author Wilson, Jefferson R.
dc.contributor.author Yee, Albert
dc.contributor.author Harrop, James S.
dc.date.accessioned 2018-03-09T12:55:06Z
dc.date.available 2018-03-09T12:55:06Z
dc.date.issued 2017
dc.identifier.citation Fehlings, M. G., Tetreault, L. A., Aarabi, B., Anderson, P., Arnold, P. M., Brodke, D. S., Burns, A. S., Chiba, K., Dettori, J. R., Furlan, J. C., Hawryluk, G., Holly, L. T., Howley, S., Jeji, T., Kalsi-Ryan, S., Kotter, M., Kurpad, S., Kwon, B. K., Marino, R. J., Martin, A. R., Massicotte, E., Merli, G., Middleton, J. W., Nakashima, H., Nagoshi, N., Palmieri, K., Singh, A., Skelly, A. C., Tsai, E. C., Vaccaro, A., Wilson, J. R., Yee, A. and Harrop, J. S. (2017) 'A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the type and timing of anticoagulant thromboprophylaxis', Global Spine Journal, 7(3S), pp. 212-220. doi: 10.1177/2192568217702107 en
dc.identifier.volume 7
dc.identifier.issued 3S
dc.identifier.startpage 212
dc.identifier.endpage 220
dc.identifier.issn 2192-5682
dc.identifier.uri http://hdl.handle.net/10468/5597
dc.identifier.doi 10.1177/2192568217702107
dc.description.abstract 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. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Sage Publications en
dc.relation.uri http://journals.sagepub.com/doi/10.1177/2192568217702107
dc.rights © 2017, the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/ ) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). en
dc.rights.uri http://www.creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject Anticoagulant thromboprophylaxis en
dc.subject Acute spinal cord injury en
dc.subject Traumatic spinal cord injury en
dc.subject Spinal cord injury en
dc.subject Anticoagulant en
dc.subject Thromboprophylaxis en
dc.subject Guideline en
dc.title A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the type and timing of anticoagulant thromboprophylaxis en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Lindsay A. Tetreault, Medicine, University College Cork, Cork, Ireland. +353-21-490-3000 Email: 116100017@umail.ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder AOSpine
dc.contributor.funder Ontario Neurotrauma Foundation
dc.contributor.funder American Association of Neurological Surgeons
dc.contributor.funder Congress of Neurological Surgeons
dc.contributor.funder Gerald and Tootsie Halbert Chair in Neural Repair and Regeneration
dc.contributor.funder DeZwirek Family Foundation
dc.contributor.funder Krembil Foundation
dc.description.status Peer reviewed en
dc.identifier.journaltitle Global Spine Journal en


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© 2017, the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/ ) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). Except where otherwise noted, this item's license is described as © 2017, the Authors. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/ ) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
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