Spinal Cord Injury Thromboprophylaxis Investigators.
Prevention of venous thromboembolism in the acute treatment phase after
spinal cord injury: a randomized, multicenter trial comparing low-dose
heparin plus intermittent pneumatic compression with enoxaparin.
J Trauma. 2003 Jun;54(6):1116-24; discussion 1125-6.

BACKGROUND: The risk of venous thromboembolism is high after spinal cord
injury (SCI). This prospective, multicenter study compared unfractionated
heparin (UFH) plus intermittent pneumatic compression
(IPC) to enoxaparin alone as thromboprophylaxis after SCI. METHODS: Patients
with acute SCI were randomly assigned to receive either UFH,
5,000 U every 8 hours, in combination with IPC or enoxaparin, 30 mg
every 12 hours. Outcome measures were deep vein thrombosis, pulmonary
embolism, and major bleeding after 2 weeks of prophylaxis.
RESULTS: Among 107 assessable patients, the incidence of venous
thromboembolism was 63.3% with UFH-IPC versus 65.5% with enoxaparin
(p = 0.81). The incidence of PE was 18.4% with UFH-IPC versus 5.2% with
enoxaparin (p = 0.03). Among all randomized patients, the incidence of major
bleeding was 5.3% with UFH-IPC versus 2.6% with enoxaparin
(p = 0.14). CONCLUSION: In the acute treatment phase after SCI, safety and
thromboprophylactic efficacy were generally similar with UFH-IPC and enoxaparin.