Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study
- Author:
Keun Hyuk KO
1
;
Ji Hoon KANG
;
Sa Yoon KANG
;
Jung Seok LEE
;
Sook Keun SONG
;
Jung Hwan OH
;
Joong Goo KIM
;
Eun Young HAN
;
Ho Kyu LEE
;
Jay Chol CHOI
Author Information
- Publication Type:Original Article
- Keywords: Venous thromboembolism; Stroke; Venous thrombosis
- MeSH: Aged; Asian Continental Ancestry Group; Cohort Studies; Female; Humans; Incidence; Leg; Lower Extremity; Male; Mass Screening; Plasma; Prospective Studies; Pulmonary Embolism; Risk Factors; Stroke; Ultrasonography; Venous Thromboembolism; Venous Thrombosis
- From: Journal of Neurocritical Care 2018;11(2):102-109
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Asians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. METHODS: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ≥18 years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7–14 and 15–28 after stroke onset. RESULTS: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7–14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2–16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. CONCLUSION: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.
