1.Deep Venous Thrombosis in Stroke Patients : An Analysis of the Rehabilitation Patient Database of the Japanese Association of Rehabilitation Medicine
The Japanese Journal of Rehabilitation Medicine 2012;49(3):137-141
As a scholarly research activity using “the Japanese Association of Rehabilitation Medicine rehabilitation patient database”, we performed an analysis with the objective of clarifying the actual conditions of DVT in stroke patients. The subjects consisted of 345 stroke patients with DVT data from the “December 2010 version" of the database. In 9 of the 345 cases (2.6%), DVT complications were observed. No significant relevance among NIHSS, mRS, or the FIM score was found at the time of admission to hospital. In addition, no association with the number of days from the onset of PT (which is believed to be a related factor) and the onset of DVT was observed. For the acute condition change rate, the DVT complication group was observed to have a significantly high rate. Moreover, for the home recovery rate, the DVT complication group was observed to have a significantly low rate. Therefore, using only the severity of the condition at the time of admission and the length of the period until the commencement of rehabilitation, it is difficult to predict the onset of DVT, and it was shown that there is a danger of DVT occurring in any stroke patient. Furthermore, the acute condition change rate when DVT occurs as a complication is high. As a result, it is therefore necessary to be vigilant in the prevention and early diagnosis of DVT.
2.The Risk of Deep Vein Thrombosis of the Lower Extremities in Patients with Chronic Respiratory Disorders, based on the Results of Ultrasonography Screening
Yuichiro SOGAWA ; Fumitoshi YOSHIMINW ; Kazuhiko HANZAWA
The Japanese Journal of Rehabilitation Medicine 2008;45(1):40-45
We screened patients with chronic respiratory disorders for deep vein thrombosis (DVT) of the lower extremities using ultrasonography. These patients require pulmonary rehabilitation because of their physical disabilities and the reduction in their activities of daily living (ADL). The average soleus vein diameter, which is the reported source of most DVTs, was 6.1±1.5 mm in the control group, 6.8±2.1 mm in the home oxygen therapy (HOT) patients, and 7.0±1.6 mm in the non-HOT patients. The soleus vein diameters in the HOT and non-HOT patients were significantly greater than in the control group (p=0.003). The prevalence of calf DVTs in the HOT patients was significantly higher than in the non-HOT patients (14.3 % vs. 2.0 %, p=0.027). Therefore, patients with chronic respiratory disorders are at greater risks of developing DVT. Furthermore, it appears that not only the deterioration in ADL but also the presence of respiratory disorders and a hypoxic state may influence the onset of DVT in HOT patients. Chronic respiratory disorder is thought to be one of the risk factors for DVT. Therefore, preventive measures, such as ultrasonographic screening examinations, daily living guidance, and physical therapy, are important for patients with chronic respiratory disorders.