Prevalence of Venous Thromboembolism in Acute Hemorrhagic and Thromboembolic Stroke

Gregory, Patricia; Kuhlemeier, K.V.

doi:10.1097/01.phm.0000064725.62897.a5

Cited by 75 publications

(47 citation statements)

References 20 publications

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Section: Thromboprophylaxis In Ich Patientsmentioning

confidence: 99%

“…110 Women and blacks may be at greater risk. [110][111][112] In a randomized trial of 151 ICH patients, intermittent pneumatic compression together with elastic stockings reduced the occurrence of asymptomatic deep vein thrombosis (DVT) after ICH compared with elastic stockings alone (4.7% versus 15.9%). 113 The CLOTS trials (Clots in Legs or Stockings After Stroke) consisted of 3 different randomized trials (CLOTS 1, 2, and 3) that assessed several different treatments, including graduated compression stockings versus none, thigh-high graduated compression stockings versus calf-high stockings, and intermittent pneumatic compression versus none.…”

Section: Thromboprophylaxis In Ich Patientsmentioning

confidence: 99%

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Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Hemphill¹,

Greenberg²,

Anderson³

et al. 2015

Stroke

2,894

1,196

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2032Purpose-The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of spontaneous intracerebral hemorrhage. Methods-A formal literature search of PubMed was performed through the end of August 2013. The writing committee met by teleconference to discuss narrative text and recommendations. Recommendations follow the American Heart Association/American Stroke Association methods of classifying the level of certainty of the treatment effect and the class of evidence. Prerelease review of the draft guideline was performed by 6 expert peer reviewers and by the members of the Stroke Council Scientific Oversight Committee and Stroke Council Leadership Committee. Results-Evidence-based guidelines are presented for the care of patients with acute intracerebral hemorrhage. Topics focused on diagnosis, management of coagulopathy and blood pressure, prevention and control of secondary brain injury and intracranial pressure, the role of surgery, outcome prediction, rehabilitation, secondary prevention, and future considerations. Results of new phase 3 trials were incorporated. Conclusions-Intracerebral hemorrhage remains a serious condition for which early aggressive care is warranted.These guidelines provide a framework for goal-directed treatment of the patient with intracerebral hemorrhage.

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Section: Thromboprophylaxis In Ich Patientsmentioning

confidence: 99%

Section: Thromboprophylaxis In Ich Patientsmentioning

confidence: 99%

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Hemphill¹,

Greenberg²,

Anderson³

et al. 2015

Stroke

2,894

1,196

View full text Add to dashboard Cite

show abstract

“…In a retrospective study of 1926 patients with ICH, 1.6% had a clinical diagnosis of venous thromboembolism as documented by the International Classification of Diseases-9th Revision clinical modification (ICD-9-CM) codes. 94 Studies using fibrinogen scanning or MRI to detect occult venous thrombosis report high frequencies (10% to 50%) of deep vein thrombosis in acute stroke patients with hemiplegia. 95 The question is how to prevent and treat these venous thromboembolic complications without increasing the risk of intracranial rebleeding.…”

Section: Prevention Of Deep Vein Thrombosis and Pulmonary Embolismmentioning

confidence: 99%

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Broderick¹,

Connolly²,

Feldmann³

et al. 2007

Circulation

312

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“…Patients with ICH are at high risk for DVT and PE, with 4-fold higher rates than in patients with acute ischemic stroke. 6,7 Prophylaxis for VTE includes sequential compression devices (nonpharmacological) and low-dose anticoagulant medications (pharmacological). American Heart Association/ American Stroke Association guidelines have recommended low-dose unfractionated heparin or low-molecular weight heparin use early after ICH since 2007 8 and currently recommend initiation between 1 and 4 days after ICH onset and after cessation of active bleeding (class IIb, level of evidence B).…”

mentioning

confidence: 99%

Is Prophylactic Anticoagulation for Deep Venous Thrombosis Common Practice After Intracerebral Hemorrhage?

Prabhakaran

Herbers

Khoury

et al. 2015

Stroke

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Background and Purpose— Prophylactic anticoagulation for deep venous thrombosis prevention after intracerebral hemorrhage (ICH) is safe. Current guidelines recommend prophylactic anticoagulation after cessation of hematoma growth. We aimed to evaluate nationwide trends in deep venous thrombosis prophylaxis after ICH. Methods— In an analysis of the Premier database, we identified adult patients with ICH ( International Classification of Diseases Ninth edition code 431) from 2006 to 2010 who survived to day 2 of hospitalization. We excluded those with trauma or who underwent craniotomy or angiography. We abstracted type of anticoagulant used and date of first administration. We used univariate statistics and multivariable logistic regression to assess factors associated with prophylactic anticoagulation after ICH. Results— Among 32 690 (mean age, 69.7 years; 50.1% men) patients with spontaneous ICH, 5395 (16.5%) patients received any prophylactic anticoagulation during the hospital stay. Among these patients, 2416 (44.8%) received prophylactic anticoagulation by day 2. The most commonly used agents were heparin (71.1%), enoxaparin (27.5%), and dalteparin (1.4%). The proportion of patients receiving prophylactic anticoagulation increased slightly during the study period from 14.3% to 18.0% ( P <0.01 for trend). Use of prophylactic anticoagulation varied by geographic region ( P <0.001) in the United States: Northeast (23.2%), South (19.0%), Midwest (10.8%), and West (9.8%). In multivariable analysis, geographic region remained an independent predictor of prophylactic anticoagulation. Conclusions— Less than 20% of patients with ICH receive anticoagulation for deep venous thrombosis in the United States. When used, the time to initiation is <2 days in less than half of the patients. Further study should focus on understanding variations in practice and emphasize guideline-driven care.

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Prevalence of Venous Thromboembolism in Acute Hemorrhagic and Thromboembolic Stroke

Abstract: DVT prevalence and risk was higher among patients with hemorrhagic strokes in comparison with patients with thromboembolic strokes.

Cited by 75 publications

References 20 publications

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

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Is Prophylactic Anticoagulation for Deep Venous Thrombosis Common Practice After Intracerebral Hemorrhage?

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