Higher risk of deep vein thrombosis after hemorrhagic stroke than after acute ischemic stroke

Abstract

Patients with stroke are at particularly increased risk of developing deep vein thrombosis (DVT) during hospitalization. In this study, we aimed to compare the potential risk of in-hospital DVT by stroke subtypes. This study is based on a prospective cohort (in-hospital medical complication after acute stroke [iMCAS] registry) enrolling patients with acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). In-hospital DVT was diagnosed by clinical manifestations and verified by compression Doppler ultrasound. A logistic regression analysis was performed to assess the association between stroke subtypes and occurrence of DVT. A total number of 1,771 patients were enrolled in the iMCAS. The mean age was 57.1±12.9 years, and 27.5% were female patients. The median length of stay was 14days (interquartile range [IQR], 11-16). The median National Institutes of Health Stroke Scale score on admission for patients with AIS, ICH, and SAH was 4 (IQR: 2-8), 4 (IQR:1-10), and 0 (IQR:0-0), respectively. In-hospital DVT after AIS, ICH, and SAH was 1.9%, 5.7%, and 7.9%, respectively. The median time from stroke onset to DVT formation after AIS, ICH, and SAH was 10.5days (IQR:3.8-14.5), 7.5days (IQR:4.0-9.5), and 7.0days (IQR:5.0-12.5), respectively. After adjusting for potential confounders, patients with ICH (odds ratio=7.350; 95% confidence interval=2.411-22.13; P<.001) and SAH (odds ratio=11.92; 95% confidence interval=5.192-27.38; P<.001) had significantly higher risk of in-hospital DVT than those patients with AIS. In conclusion, patients with hemorrhagic stroke (ICH and SAH) have significantly higher risk of in-hospital DVT than patients with AIS. Further studies on pathophysiologic mechanisms are warranted.