Prevalence of deep vein thrombosis in patients with stroke in the first three days of hospitalization

Abstract

Introduction. Sonography of lower extremity veins is advised to be used for evaluation VTE in patients with stroke, however, the timing of the evaluation remains uncertain, therefore the prevalence of VTE and associated factors in different time intervals of hospitalization is necessary to be studied. Aim – to investigate the prevalence of lower extremity veins thrombosis by sonography compared with the prevalence of associated factors (D-dimer level in the blood, the risk of VTE by Padua score system) in patients with stroke in the first 3 days of hospitalization. Materials and methods. The study enroled 50 patients hospitalized in the Botkin State Clinical Hospital of Moscow with stroke. Sonography of lower extremity veins was performed, the level of D-dimer in the blood was determined, the risk of VTE by Padua score system was assessed in the first 3 days of hospitalization. The prevalence of these indicators has been studied. Results. Increased D-dimer level was detected in the majority of patients: 84 % of all patients (42 of 50), 85 % of patients with ischemic stroke (34 of 40), 78 % with hemorrhagic stroke (7 of 9) and in a single patient with TIA. 30 % of all patients (15 of 50), 32.5 % of patients with ischemic stroke (13 of 40), 22 % of patients with hemorrhagic stroke (2 of 9) had high risk of VTE according to Padua (≥ 4 points). The prevalence of lower extremity veins thrombosis according the sonography results was 6 % (3 of 50), that is 14 times less than the prevalence of increased D-dimer level and 5 times less than the prevalence of high risk of VTE by Padua score system. About 66 % of mpatients having thrombosis (2 of 3) were suffering from active cancer. Conclusion. Patients with stroke in the first 3 days of hospitalization has significant prevalence of lower extremity deep vein thrombosis according to sonography, but factors that distinguish these patients need to be clarified. Lower prevalence of increased D-dimer level and the high risk of VTE by Padua in post-stroke patients during this period of hospitalization seem to be doubtful criteria compared with prevalence of lower extremity deep vein thrombosis for selection to sonography. The distinguishing risk factor for VTE by Padua in 66 % of patients with evaluated deep vein thrombosis in the first 3 days of hospitalization with stroke was an active cancer.