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Effects of the 5E Program on Venous Thromboembolism Prevention in Patients
with Spinal Cord Disorders

S. Chindamart and W. Potisopha 2
1

1 2
Department of Orthopedics, Chaiyaphum Hospital, Thailand, and Faculty of Nursing, Khon Kaen
University, Thailand

Background: Venous thromboembolism (VTE) is a major complication in patients with spinal cord
disorders. Due to the bleeding risk after pharmaceutical prophylaxis, a VTE-preventing program has been
developed based on the concepts of Virchow’s Triad by integrating several non-pharmaceutical methods
for this population.

Objective: To examine the effects of the 5E (Education, Exercise, Elevation, Enough Fluid, and Early
Application of Intermittent Pneumatic Compression) program on VTE prevention among patients with
spinal cord disorders.

Methods: This quasi-experimental research was conducted between January and April 2024.
Forty-two patients with spinal cord diseases who were admitted to the orthopedics departments
of Chaiyaphum Hospital were recruited for this study. Twenty-one participants in the control group
received hospital-standard care, and 21 in the experimental group received the 5E Program for
seven days. The outcomes were VTE diagnosed by ultrasound doppler (baseline, Day 7), Well’s Score
for deep vein thrombosis and Modified Clinical Well’s Score for pulmonary embolism (baseline, Day
1–7), and thigh and calf circumferences (baseline, Day 1–7). The Fisher exact probability test and the
Friedman test statistic were deployed in data analysis.

Results: The rate of VTE in the control group (9.5%) was higher than the 5E program group (4.8%),
Oral Presentation Abstracts
but they were not significantly different. Well’s scores and modified Well’s clinical scores of both
experimental and control groups in the baseline and days 1–7 increased by days, but these
changes were not significantly different. The circumferences of both thighs and calves in the
experimental group were not significantly different before and after receiving the 5E program.

Conclusion: The 5E program can help to prevent the change of thigh and calf circumferences among
patients with spinal cord diseases during the period of 7 days. The evaluation period of the 5E program
should be extended in the future.

Keywords: spinal cord disorders, venous thromboembolism, 5E program

_____________________________________________________________________________________________________
Correspondence: Wiphawadee Potisopha, Faculty of Nursing, Khon Kaen University, Thailand
E-mail: wiphpo@kku.ac.th

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