Analysis of risk factors associated with pulmonary embolism in patients with spinal cord injury: A meta-analysis

Pulmonary Embolism (PE) represents a life-threatening complication in patients with Spinal Cord Injury (SCI), yet comprehensive evidence regarding its risk factors remains limited. This meta-analysis aimed to systematically evaluate risk factors associated with PE development in SCI patients.

A systematic literature search was conducted across major electronic databases (PubMed, Cochrane database, Embase, CNKI, and Wanfang), identifying studies that reported risk factors for PE in SCI patients. Pooled Odds Ratios (ORs) with 95% Confidence Intervals (95% CIs) were calculated using fixed-effect or random-effects models. Study quality was evaluated using the Newcastle-Ottawa Scale.

Nine studies encompassing 394,322 SCI patients were included, with an overall PE incidence of 0.125%. Meta-analysis revealed that older age (OR = 1.80, 95% CI 1.49-2.17, p < 0.001), prolonged operative time (OR = 2.56, 95% CI 1.84-3.56, p < 0.001), history of deep vein thrombosis or PE (OR = 29.10, 95% CI 14.03-60.37, p < 0.001), and traumatic injury etiology (OR = 3.15, 95% CI 1.37-7.22, p = 0.007) were significantly associated with increased PE risk. Conversely, sex, body mass index, and comorbidities showed no significant associations with PE development. Sensitivity analyses confirmed the robustness of these findings.

This meta-analysis identifies older age, prolonged operative time, prior thromboembolic history, and traumatic injury as significant risk factors for PE in SCI patients. These findings provide evidence-based guidance for risk stratification and implementation of targeted prophylactic strategies in this vulnerable population.