Patient selection: acute traumatic spinal cord injury
Thromboprophylaxis: with unfractionated or low molecular weight heparin
Risk factors for thromboemboli despite thromboprophylaxis:
(1) family history of venous thromboemboli
(2) prothrombin gene mutation G20210A
(3) elevation plasma levels of Factor VIII
(4) elevated plasma homocysteine concentration
where:
• An additional risk factor might be a personal history of venous thromboembolism or failure of heparin prophylaxis.
A patient with one or more of these risk factors:
(1) may require a higher dose of heparin or alternative anticoagulant
(2) may require a longer course of anticoagulation
(3) may require placement of a vena caval filter
