Article

Qualitative systematic review. OBJECTIVES: To examine the validity
of the prevailing notion that pulmonary embolism (PE) is rare in the chronic
spinal cord injury (SCI) population. SETTING: USA. METHODS: Review surveys of
adult SCI subjects >2 months after injury in which PE has been looked for and its
prevalence estimated. RESULTS: A total of 16 surveys of chronic SCI subjects
published between 1956 and 2009 offered data on PE prevalence. Two autopsy
surveys, 178 subjects paralyzed >2 months, revealed no PE. Eleven surveys of the
cause of death, 3193 subjects paralyzed 1-25 years, revealed PE in 2.1%. Two
surveys of survivors of SCI, 5761 subjects paralyzed 1-25 years, revealed PE in
0.4%. Our survey of 112 subjects paralyzed 1-50 years before death, revealed PE
in 21 (18.7%), based on autopsy, imaging, clinical and electrocardiographic
evidence. In 7 (33%) of the 21 subjects with PE, pulmonary hypertension by
transthoracic echocardiography was detected, indicating recurrent and/or
unresolved PE. CONCLUSION: PE is not infrequent in the chronic SCI subject; but
its presentation may be subclinical; and its apparent recurrence may lead to
pulmonary hypertension.

Langue : ANGLAIS