Risk factors for pulmonary embolism in patients with acute spinal cord injury

Objective To investigate the risk factors for pulmonary embolism (PE) in patients with acute spinal cord injury (ASCI). Methods A case-control design was adopted in this study. Basic information, injury cause, injury site, imaging and laboratory examination results and other relevant data of 840 ASCI patients admitted to 3 affiliated hospitals of Army Medical University from January 2018 to August 2023 were collected. According to occurrence of PE or not, these patients were divided a PE group (n=83) and a non-PE group (n=757). Univariate analysis was performed on 37 risk factors including gender, age, length of hospital stay, length of intensive care unit (ICU) stay, cause of injury, and so on, and then multivariate logistic regression analysis was applied to analyze these selected significant variables. Results Univariate analysis showed that 24 factors such as age, length of hospital stay, lower limb fracture, pulmonary contusion and infection, shock and number of operations were related to the occurrence of PE in ASCI patients (P<0.05). Binary logistic regression analysis indicated that age (P=0.000, OR=1.957, 95%CI: 1.532~2.499), length of ICU stay (P=0.000, OR=2.561, 95%CI: 1.728~3.794), number of operations (P=0.015, OR=1.814, 95%CI: 1.124~2.927), spinal fixation (P=0.004, OR=0.370, 95%CI: 0.189~0.724), restrictive position (P=0.000, OR=21.269, 95%CI: 5.276~85.740), platelet count (P=0.000, OR=1.553, 95%CI: 1.236~1.951), D-dimer level (P=0.000, OR=1.600, 95%CI: 1.376~1.860) and prothrombin time (P=0.025, OR=2.756, 95%CI: 1.138~6.670) were independent risk factors for PE in the patients. Conclusion The mortality of the ASCI patients with PE is significantly higher than those without. Age, length of ICU stay, number of operations, spinal fixation, restrictive position, platelet count, D-dimer level and prothrombin time are closely associated with PE in ASCI patients.