Deep venous thrombosis of the legs after strokes. Part I--incidence and predisposing factors.

Warlow, Charles; Ogston, D.; Douglas, A.G.

doi:10.1136/bmj.1.6019.1178

Cited by 190 publications

(49 citation statements)

References 20 publications

(5 reference statements)

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“…9 An association between early mobilization and reduced number of complications, such as pneumonia, is yet unproven and results of previous studies vary. 9,10 This individual patient data meta-analysis, by adjusting for confounders, has provided a more reliable estimate of effect than previously reported in the individual studies. 6,7 This has important implications considering that regaining independence in activities such as walking after stroke is thought to be one of the most important rehabilitation goals for patients.…”

Section: Discussionmentioning

confidence: 88%

Early Mobilization After Stroke

Craig

Bernhardt

Langhorne

et al. 2010

Stroke

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Background and Purpose-Very early mobilization (VEM) is a distinctive characteristic of care in some stroke units; however, evidence of the effectiveness of this approach is limited. To date, only 2 phase II trials have compared VEM with standard care: A Very Early Rehabilitation Trial (AVERT) in Australia and the recently completed Very Early Rehabilitation or Intensive Telemetry after Stroke trial in the United Kingdom. The Very Early Rehabilitation or Intensive Telemetry after Stroke protocol was designed to complement that of AVERT in a number of key areas. The aim of this analysis was to investigate the impact of VEM on independence by pooling data from these 2 comparable trials. Methods-Individual data from the 2 trials were pooled. Overall, patients were between 27 and 97 years old, had first or recurring stroke, and were treated within 36 hours after stroke onset. The primary outcome was independence, defined as modified Rankin scale score of 0 to 2 at 3 months. The secondary outcomes included complications of immobility and activities of daily living. Logistic regression was used to assess the effect of VEM on outcome, adjusting for known confounders including age, baseline stroke severity, and premorbid modified Rankin scale score. Findings-All patients in AVERT and

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Section: Discussionmentioning

confidence: 88%

Early Mobilization After Stroke

Craig

Bernhardt

Langhorne

et al. 2010

Stroke

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“…Several studies have demonstrated that hormone replacement therapy can increase risk of thrombosis by 2 to 4 folds [61][62][63]. The risk is even more increased in case of older and overweight women or those with factor V Leiden or high factor IX levels [64,65].…”

Section: Hormone Replacement Therapymentioning

confidence: 99%

“…There is an increased risk of venous thrombosis during all circumstances that are associated with immobilization of body extremities such as bed rest, paralysis, plaster casts etc [52].…”

Section: Immobilizationmentioning

confidence: 99%

Understanding Genetic Variations as Risk Factors for Development Venous Thrombo-Embolism (VTE)

Srivastava¹

2016

Adv Genet Eng

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Venous thrombosis (VT) possess a major health problem worldwide and has a high incidence in several populations across the world. Its two clinical manifestations include deep vein thrombosis (DVT) and pulmonary embolism (PE). The pathogenetic mechanism of venous thromboembolism (VTE) is still not completely elucidated, however there are clear evidences that the process occurs by complex interaction of genetic and environmental factors, wherein, genetic risk factors plays a major role. These numerous conditions that are known for predisposition of venous thromboembolism are commonly referred to as 'risk factors'. Classical risk factors for VTE include advancing age, prolonged immobilization, surgery, use of oral contraceptives or hormones, pregnancy, cancer etc. However, in the recent decades, studies have emerged that indicating a major role of novel genetic risk factors. These genetic risk factors include genes related to haemostatic system and coagulation cascade. Understanding the of role of these genes as predisposing factors for VTE represent a crucial step for a better understanding of pathogenesis of thrombosis. Several genes that have been studied for their mutations playing a role in VTE are factor V Leiden (FVL), antithrombin (AT), protein C, protein S, prothrombin, fibrinogen etc. The risk associated with each genetic defect might be relatively insignificant when studied individually but simultaneous involvement of several mutations increase the risk of susceptibility. In addition to this, acquired risk factors interacting with one or more genetic variations further add to the risk of VTE. This review has been complied to interrogate the role of several genetic and acquired risk factors across various populations as investigated in numerous studies.

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“…It is also very difficult to identify a low-risk group within the PREVAIL population. Leg weakness predominantly defines VTE risk after stroke, 1,12 and subgroup analyses identified no difference in benefit irrespective of age, sex, stroke severity, or obesity. It seems unlikely therefore that it will be possible to easily define a risk score that could target treatment any better than the trial entry criteria achieved.…”

mentioning

confidence: 99%

“…Studies of the natural history in the era before widespread use of antiplatelet agents or physical preventive measures reported an incidence of deep vein thrombosis (DVT) of over 50% within the first days. 1 A lower incidence might be expected with more aggressive routine acute treatment, including early use of antiplatelet agents, early mobilization, and graduated compression stockings, but the combined control groups of randomized, controlled trials (RCTs) predominantly undertaken in the 1990s still reported an incidence of 37% when DVT was specifically sought. 2 Older studies found the incidence of pulmonary embolism (PE) after stroke to be 10% to 20% and to account for up to 10% of all fatalities (including cases in ambulant patients).…”

mentioning

confidence: 99%

The PREVAIL Trial and Low-Molecular-Weight Heparin for Prevention of Venous Thromboembolism

Muir

2008

Stroke

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Deep venous thrombosis of the legs after strokes. Part I--incidence and predisposing factors.

Cited by 190 publications

References 20 publications

Early Mobilization After Stroke

Early Mobilization After Stroke

Understanding Genetic Variations as Risk Factors for Development Venous Thrombo-Embolism (VTE)

The PREVAIL Trial and Low-Molecular-Weight Heparin for Prevention of Venous Thromboembolism

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