Risk Assessment of Deep‐Vein Thrombosis After Acute Stroke: a Prospective Study Using Clinical Factors

Liu, Liping; Zheng, Huaguang; Wang, David Z.; Wang, Yilong; Hussain, Mohammed; Sun, Haixin; Wang, An-Xin; Wang, Wenjuan; Dong, Kun; Wang, Chunxue; He, Wen; Ning, Bin; Wang, Yongjun

doi:10.1111/cns.12227

Cited by 48 publications

(75 citation statements)

References 40 publications

(38 reference statements)

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“…Immobility was a major risk factor for DVT in neurological diseases (4,18).An observational research analyzed 542 stroke patients with DVT and found that DVT occurred in 73% of patients with weaker muscle strength while only 11% of patients with stronger were diagnosed with DVT (19). Our study showed that there was no difference in muscle strength between DVT-group and non-DVT group.…”

Section: Analysis Of the Changes In Laboratory Variables When Dvt Detmentioning

confidence: 51%

“…Stroke is one of the severe cerebral disorders leading to high disability and mortality among hospitalized patients(1), while deep vein thrombosis (DVT) is one of most common and fatal complications in patients after stroke (2). In western countries, the incidence of DVT in acute stroke patients without prophylactic treatment was up to around 80% (3), and DVT still occurred in at 2-3% of patients even receiving comprehensive prophylactic therapy (4,5). The CLOTS trial, as a largest multicenter observational research with 5632 patients with stroke revealed that the in-hospital incidences of detected DVT within 10 days and within 30 days were 11% and 15%, respectively (6).…”

Section: Introductionmentioning

confidence: 99%

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Association of Clinical and Laboratory Variables with In-Hospital Incidence of Deep Vein Thrombosis in Patients with Acute Stroke: A Retrospective Study

Huang

Song

Peng

et al. 2020

Preprint

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Abstract Backgrounds: Deep vein thrombosis (DVT) is a serious complication in patients with acute stroke. Early prediction of DVT could enable physicians to perform a proper prevention strategy. We analyzed the association of clinical and laboratory variables with DVT to evaluate the risk of DVT in patients after stroke.Results: Acute stroke patients admitted to the Changsha Central Hospital between January 2016 and December 2019 with length of stay in hospital≥30 d were included. Clinical and laboratory variables for DVT at baseline were collected, and the diagnosis of DVT was confirmed by ultrasonography. Risk factors were developed by Multivariate logistic regression analysis. A total of 101 patients were included in the study, of which 77.2%(78/101) were diagnosed ischemic stroke and 22.8%(23/101)were confirmed hemorrhagic stroke. The overall incidence of DVT after acute stroke within 30 days was 19.8%(20/101). The level of D-dimer when DVT detected was significant increased than that on admission. Pulmonary infection and increased muscle tone as independent relevant factors for DVT were confirmed. Conclusions: Pulmonary infection as a risk factor and increased muscle tone as a protector factor for DVT were identified in patients after stroke and the significant change in level of D-dimer could be a warning for DVT occurrence. It helps with taking early managements to reduce the incidence of DVT in patients after stroke.

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Section: Analysis Of the Changes In Laboratory Variables When Dvt Detmentioning

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Association of Clinical and Laboratory Variables with In-Hospital Incidence of Deep Vein Thrombosis in Patients with Acute Stroke: A Retrospective Study

Huang

Song

Peng

et al. 2020

Preprint

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“…The overall prevalence of clinically evident deep vein thrombosis (DVT) after acute stroke is around 2-20% and it develops mainly between two and seven days after the event [2]. It can lead to post-thrombotic leg and varicose ulcers in addition to delaying rehabilitation.…”

Section: Risk Assessment Of Deep-vein Thrombosis and Epidemiology Of mentioning

confidence: 99%

“…Factors with positive predictive value of DVT poststroke are: y female gender; y older age; y body mass index (BMI) ≥ 25 kg/m 2 ; y cancer; y hemorrhagic subtype stroke; and y a lower limb NIHSS score ≥ 2 [2].…”

Section: Risk Assessment Of Deep-vein Thrombosis and Epidemiology Of mentioning

confidence: 99%

A temible complication of ischemic stroke: pulmonary embolism

Iurato

Randisi²,

Torrisi

et al. 2015

CMI

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Stroke is a leading cause of death and disability and is the third highest cause of death in the western world. Medical illness after ischemic stroke contribute substantially to poor stroke outcomes. The early in-hospital complications of stroke patients are mainly: pneumonia (hospital acquired pulmonary infection), increased intracranial pressure (neuroimaging evidence of cerebral edema or brain shift syndrome with clinical deterioration), urinary tract infection, intracerebral bleeding, recurrent stroke, epileptic seizures, thrombosis or pulmonary embolism. All these complications influence the patient's outcomes and require diagnostic and therapeutic measures. Pulmonary embolism is a major contributor to in-hospital death after stroke. Although the rate of clinically overt pulmonary embolism after stroke has been estimated to be less than 1%, pulmonary emboli account for up to 50% of early deaths after stroke. In daily practice, the clinical burden of pulmonary embolism in patient with stroke is, however, underestimated since the clinical symptoms of stroke may obscure the recognition of this complication. The aim of this article is to describe the clinical and therapeutic aspects of pulmonary embolism as complication after stroke. Keywords

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“…Although risk factors for stroke-related DVT are still debated, advanced age, high NIHSS score, hemiparesis, immobility, female sex, atrial fibrillation, intravenous or intra-arterial tissue plasminogen activator (tPA), and length of hospital stay have been identified 16,28,29) . Male sex is considered to be highly associated with DVT in the general population 2,12,26,30,31,37) .…”

Section: Introductionmentioning

confidence: 99%

Deep Vein Thrombosis and Pulmonary Embolism following Hemorrhagic Stroke

Lee

Jeong

Choi

et al. 2018

J Neurointensive Care

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Venous thromboembolism (VTE) after stroke is an infrequent but potentially fatal medical complication. The incidence of VTE was shown to be higher in hemorrhagic stroke than in ischemic stroke by several studies; however, no strategy for VTE screening and prophylaxis has been established. Lower extremity ultrasonography (US) is the diagnostic method of choice, but routine application for stroke patients is still debated. For prevention, graduated compression stockings (GCS) have little effect on VTE, and thigh-high GCS should be selected. Early use of intermittent pneumatic compression (IPC) has strong evidence for preventing VTE and is recommended in several clinical guidelines for managing intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). Prophylactic heparin products are still debated for preventing VTE despite the risk of rebleeding or hematoma enlargement. To date, administering low-dose, low-molecular-weight heparin (LMWH) seems the best method to prevent VTE with less risk of hemorrhagic complications. However, the optimal product, dose, and timing are unclear.

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Risk Assessment of Deep‐Vein Thrombosis After Acute Stroke: a Prospective Study Using Clinical Factors

Abstract: This clinical score may help identify acute stroke patients with high risk of DVT. In addition, it also serves as a platform to develop further models of DVT prediction in stroke patients based on clinical factors.

Cited by 48 publications

References 40 publications

Association of Clinical and Laboratory Variables with In-Hospital Incidence of Deep Vein Thrombosis in Patients with Acute Stroke: A Retrospective Study

Association of Clinical and Laboratory Variables with In-Hospital Incidence of Deep Vein Thrombosis in Patients with Acute Stroke: A Retrospective Study

A temible complication of ischemic stroke: pulmonary embolism

Deep Vein Thrombosis and Pulmonary Embolism following Hemorrhagic Stroke

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