Deep Vein Thrombosis In Stroke Patients Research Articles

ИНСУЛЬТ МЕНЕН ООРУГАН БЕЙТАПТАРДАГЫ ТЕРЕҢ ТАМЫР ТРОМБОЗУНУН ТОБОКЕЛДИК ФАКТОРЛОРУ ЖАНА БОЖОМОЛДООЛОРУ (ИЛИМИЙ АДАБИЯТТАРДЫ КАРАП ЧЫГУУ)

Currently there is no reliable evaluation system for predicting deep vein thrombosis (DVT) in the hospital after ischemic and even more – hemorrhagic stroke. Objective: to review current literature data on the verification of risk factors for the development of DVT in stroke patients and aggressive and early screening strategies in the early post-stroke period. Three fundamental factors underlie the development of DVT: damage to the venous wall, the tendency of blood to hypercoagulation and slow blood flow. Most of the factors that are more or less associated with the development of thromboembolic events revolve around these 3 elements. Typical factors were older age, female gender, changes in the levels of clinical and laboratory variables such as D-dimer or scores on the Berg equilibrium scale. An effective model of risk stratification for DVT at the hospital level after a stroke would be useful for identifying high-risk patients and for implementing individual preventive strategies, therefore further population studies are needed, including in Kyrgyzstan.

A Nomogram for Predicting the Risk of Deep Vein Thrombosis in Patients With Acute Ischemic Stroke During the COVID-19.

Deep vein thrombosis (DVT) is an important complication of stroke. As coronavirus disease 2019 (COVID-19) enters the stage of persistent and long-term management, the clinical management of DVT in stroke patients may require adjustment. The present study evaluated whether there was an increased risk of DVT in stroke patients during the COVID-19 period. Furthermore, we analyzed the possible risk factors and developed an easy-to-use nomogram to predict DVT in stroke patients during the long-term management of COVID-19. A total of 7087 stroke patients during the COVID-19 period and 14,174 patients with age, sex, and National Institutes of Health Stroke Scale (NIHSS) scores matched before the period from four centers were included. The incidence of DVT in stroke patients during the COVID-19 period (20.5%) was significantly higher than that before this period (15.9%, P < .001). Age, body mass index, smoking, D-dimer, physical activity level, NIHSS score, and intermittent pneumatic compression were significant predictors of DVT during the COVID-19 period (P < .05). A nomogram was constructed; internal and external validations showed high accuracy, and decision curve analysis showed excellent clinical applicability. This nomogram could evaluate the risk of DVT after stroke and assist in its early prevention during the long-term management of COVID-19.

The Relationship of D-dimer Levels and the Incident of Deep Vein Thrombosis in Acute Ischemic Stroke Patients at Haji Adam Malik General Hospital Medan

Background: Deep Vein Thrombosis (DVT) is the formation of a thrombus in deep veins, often observed in stroke patients due to immobilization and infection during hospitalization. High D-dimer levels are associated with DVT in stroke patients. This study aims to evaluate the association between D-dimer levels as a diagnostic tool for DVT in acute ischemic stroke patients. Methods: This cross-sectional, retrospective study was conducted from May to August 2023. The study was carried out on acute ischemic stroke patients at Haji Adam Malik General Hospital, Medan, using consecutive sampling. Doppler ultrasound was used as the gold standard, and D-dimer data were analyzed using the SPSS program, employing the Chi-square test or Fisher's exact test. Results: Of the 49 patients, 35 met the inclusion criteria. Among the patients, 24 (68.6%) were male, 23 (65.7%) were over 50 years old, and 30 (85.7%) had a Body Mass Index (BMI) between 18-24.9. The mean D-dimer value was 2153.43 (±1506.88) ng/mL. All 21 (100%) DVT cases were asymptomatic. According to the Well's score, 15 patients scored 1 (42.8%), 20 patients (57.2%) scored 2, and the probability of DVT is in the moderate range for all 35 patients. The Fisher's Exact Test yielded a p-value of 0.028 (p&lt;0.05). Conclusion: There is a significant relationship between D-dimer levels and the incidence of DVT in patients experiencing acute ischemic stroke. Keywords: Acute Ischemic Stroke, D-dimer, Deep Vein Thrombosis, Doppler Ultrasound

Application status and prospect of deep vein thrombosis risk assessment tools for stroke patients

This paper reviewed the application status of the common deep vein thrombosis (DVT) risk assessment tools for stroke patients to explore the advantages and disadvantages of every tool so as to provide a basis for selecting the best assessment tools for early DVT in stroke patients. Key words: Review; Stroke; Deep vein thrombosis; Risk assessment tools

Effect of Intermittent Pneumatic Compression on Preventing Deep Vein Thrombosis Among Stroke Patients: A Systematic Review and Meta-Analysis.

Deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) are common complications of stroke. However, the effect of intermittent pneumatic compression (IPC) for patients after stroke is uncertain. To assess the effectiveness and safety of IPC in reducing the risk of DVT, PE, and mortality in stroke patients. We searched leading medical databases including Medline, EMBASE, Cochrane Library, Wanfang, CNKI, and CBM, from inception to June 2, 2017. Studies comparing IPC with no IPC in stroke patients were included. Agreement was measured using simple agreement and kappa statistics. The rates of PE, DVT, and mortality were compared. The results were pooled using a fixed effects model to evaluate the differences between the IPC and control groups. If there was significant heterogeneity in the pooled result, a random effect model was used. We identified seven randomized controlled trials that included 3,551 stroke patients. The average calculated κ for the various parameters was κ = 0.96 (0.70-1). Overall, IPC significantly reduced the incidence of DVT in stroke patients (risk ratio [RR] = 0.50; 95% confidence interval [CI 0.27, 0.94]). At the same time, IPC increased IPC-related adverse events (RR = 5.71; 95% CI [3.40, 9.58]). Though IPC was associated with a significant increase in survival by 4.5 days during 6 months of follow-up (148-152 days; 95% CI [-0.2, 9.1]), there was a mean gain of only 0.9days (26.7-27.6days; 95% CI [2.1, 3.9]) in quality-adjusted survival during the 6-month follow-up. Overall, sensitivity analyses did not alter these findings. This review provides an important basis for preventing DVT in stroke patients, especially in hemorrhagic stroke patients. IPC significantly reduces the risk of DVT and significantly improves survival in a wide variety of patients who are immobile after stroke. However, IPC does not significantly improve quality-adjusted survival. Clinicians should take functional status and quality of life into consideration when making decisions for stroke patients.

急性期脳卒中センターにて深部静脈血栓症を合併した3症例

In our acute stroke care center, we sometimes encounter problems of deep vein thrombosis (DVT), a problem that has been increasing in recent years. There is presently consensus regarding the treatment for urgent cases of DVT, but there is no established policy regarding non-urgent cases. We reviewed the therapeutic courses of the three cases (of which two were symptomatic and the other asymptomatic) in which the stroke patients had a complication of DVT in our facility. The first case was a 61-year-old male, who developed atherothrombotic stroke and was administered with intravenous treatment with tissue plasminogen activator. During the course, the patient was found out to have pain and swelling in the paralyzed lower leg. DVT was found, and anticoagulant treatment was administered, followed by inferior-vena-cava (IVC) filter detention. The second case was a 79-year-old female, who developed atherothrombotic stroke and was administered with anti-coagulant treatment. Respiratory discomfort was observed, and a detailed examination revealed she had a complication of pulmonary embolism (PE) and DVT. After the immediate IVC filter detention, additional anticoagulant treatment was administered. The third case was an 81-year-old male who underwent conservative treatment for brain hemorrhage. D-dimer rose during the course, and a detailed examination revealed a thrombus in the pulmonary artery and the vein in the paralyzed leg. Although he had no symptoms, elastic stockings were used to prevent PE, and anticoagulant treatment was administered. DVT has been reported about 10 percent of the patients hospitalized in rehabilitation hospitals, and it is important to detect asymptomatic DVT in stroke patients with paralysis at an early stage. Urgent cases in which PE and symptoms in lower legs are observed can be treated with IVC filter and catheter, for example. But asymptomatic DVT often goes unnoticed, and there is no consensus on its treatment. We suggest that anticoagulant treatment and the use of elastic stockings are effective in treating DVT.

Deep Vein Thrombosis in Stroke Patients Admitted to a Rehabilitation Unit in Singapore

Studies have shown that deep vein thrombosis (DVT) is common after an acute stroke. Less common are studies documenting DVT in stroke patients admitted to rehabilitation. The purpose of this study was to determine the frequency and risk factors of DVT in stroke patients admitted to a rehabilitation unit in Singapore. A prospective observational single-center study of patients with ischemic and hemorrhagic stroke with lower limb paresis admitted to a rehabilitation center in Singapore. The screening protocol consisted of quantitative D-dimer assay (DDA) within 24-48 h of rehabilitation admission followed by duplex ultrasound scan of the paretic lower extremity if DDA level was elevated (equal or greater than 0.34 microg/ml). Altogether, 341 patients were screened at a mean of 23 days poststroke. One hundred and ninety-eight (58.1%) patients had an elevated DDA and all underwent ultrasound scans. The frequency of lower limb DVT was 9% (18) - seven proximal and 11 distal. DVT was significantly related to higher D-dimer levels (P=0.029) and cortical strokes (P=0.004), but not to age, gender, race, nature of stroke, atrial fibrillation, severity of lower limb weakness, and ambulatory and functional status. No patients had clinical pulmonary embolism during rehabilitation. Lower limb DVT is uncommon in stroke patients admitted to rehabilitation in Singapore. Future research should include evaluation of the cost-effectiveness of such a screening protocol.

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Deep vein thrombosis: Prevention in stroke patients during rehabilitation

Deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) is a major source of mortality and morbidity in stroke patients. This study was designed to determine the effectiveness of different prophylactic treatments in the prevention of DVT after a stroke in patients undergoing rehabilitation. An additional objective was the identification of risk factors for DVT in stroke patients during rehabilitation. Three hundred and sixty patients, over a 3-year period, were randomly assigned to one of four groups: adjusted dose heparin, intermittent pneumatic compression (IPC), functional electrical stimulation (FES), or control. There was no significant difference in the development of DVT by treatment group. Patients with DVT on admission (prevalent, n = 61) were compared with the study patients (n = 360). Time interval (from stroke to admission) and lactic dehydrogenase (LDH) concentration were significant risk factors, as well as predictors, for development of DVT ( p < .000). These results suggest that the longer a patient remains without DVT prophylaxis after a stroke, the greater the risk of developing DVT and this supports early prophylaxis before rehabilitation.

Org 10172: reduces the rate of deep-vein thrombosis in stroke patients

Org 10172: reduces the rate of deep-vein thrombosis in stroke patients

Venous Thromboembolism after Cerebral Infarction and the Prophylactic Effect of Dextran 40

In a prospective study of the incidence of deep vein thrombosis (DVT) after stroke, and the prophylactic effect of dextran, 50 patients, admitted with a diagnosis of cerebral infarction with paresis of the lower extremity within the first 48 hours, were randomly allocated to treatment or non-treatment groups. The treatment group received 500 ml of dextran 40 on admission and on days 1 and 2, and 250 ml on days 4 and 6. Venesection was performed on admission and if necessary on day 1. The control group received no dextran or venesection. DVT was diagnosed with the 125I-fibrinogen test during the first ten days. The incidence of DVT was 54% in the treatment group and 50% in the control group. There were no statistically significant differences between the groups regarding number of DVTs needing treatment, number of positive scanning points or number of days for scan to become positive. Lethal pulmonary emboli occurred in one treated and in three control patients, respectively. Age and progress of neurologic symptoms predisposed for the development of DVT. The high incidence of DVT in stroke patients indicates the need for prophylactic routines.