Abstract T P299: Ambulatory Status: A Protective Mechanism against Venous Thromboembolism in Acute Stroke Patients

Abstract

Introduction: Deep vein thrombosis (DVT) is reported in 23% to 50% of hemiplegic stroke survivors and the highest rate of incidence occurs within one week of stroke onset. Pulmonary embolism (PE) is reported in up to 5% of stroke patients. There is limited data about the relationship of ambulatory status and the rate of venous thromboembolism (VTE) following a stroke. Hypothesis: The goal of our retrospective cohort study was to understand the relationship between VTE and a patient’s ambulatory status, adjusting for age, gender, and stroke type (ischemic, intracerebral hemorrhage, or subarachnoid hemorrhage). We assessed the hypothesis that the stroke patients who are able to ambulate during hospitalization would have lower rates of DVT and PE. Methods: We retrospectively analyzed 1670 acute stroke patients who were admitted to an academic comprehensive stroke center between Feb 2006 and May 2014. “Get with the guideline data” was used to identify stroke patients and their ambulatory status (yes/no). VTE was identified using discharge diagnosis. Chi square test and logistic regression methods were used for statistical analysis. Results: Mean age was 64.9 ± 14.6 years with 51% men. 1138 (68%) patients were classified as having ischemic stroke; 291 (17.5%) patients had intracerebral hemorrhage; and 241 (14.5%) patients had subarachnoid hemorrhage. During hospitalization, 444 (27%) were ambulatory. Patients able to ambulate during hospitalization had less rate of DVT (6.3% vs 15.3%; p<0.0001) and PE (2.9% vs 5.3%; p=0.04), when compared to non-ambulating patients. After adjusting for age, gender, and stroke type; patients who were able to ambulate still had lower rates of DVT (OR: 0.42, 95% CI 0.27-0.63) and PE (OR: 0.49, 95% CI 0.25-0.88). Conclusion: In conclusion, our findings suggest that the patient’s ambulatory status during hospitalization is an independent predictor of VTE. Further research is needed to understand if early mobilization in non-ambulatory stroke patients would have similar protective effect against VTE or not.