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Erschienen in: Journal of Thrombosis and Thrombolysis 2/2012

01.08.2012

The incidence of venous thromboembolism following stroke and its risk factors in eastern China

verfasst von: Xingyang Yi, Jing Lin, Zhao Han, Xudong Zhou, Xiaotong Wang, Jiguang Lin

Erschienen in: Journal of Thrombosis and Thrombolysis | Ausgabe 2/2012

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Abstract

Few studies have documented the prevalence of venous thromboembolism (VTE) in the Chinese population. We aimed to investigate the incidence of VTE following stroke and to determine the potential risk factors for the onset of VTE in patients of eastern China. A prospective multi-center study was conducted. A total of 1,380 patients with acute stroke received venous duplex ultrasound (VDU) examination on both lower limbs. The National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI), Wells, and modified Rankin scale scores were determined. Among 1,380 cases of acute stroke, 4.49 % (62 cases) had deep venous thrombosis (DVT) and 0.80 % (11 cases) had pulmonary thromboembolism (PTE). In the cases of DVT, 48.4 % had no clinical symptoms. The independent risk factors for the incidence of DVT, following the acute stage of stroke, were an age ≥70 years, bed-ridden, a Wells score ≥2, an NIHSS score of lower limbs ≥3, a low BI score, and an elevated concentration of D-dimer. Rehabilitative and anti-coagulant therapy prevented the incidence of DVT following stroke. Moreover, an age ≥70 years, bed-ridden and having DVT were the independent risk factors for the incidence of PTE among stroke patients during the acute stage. Finally, 1.51 % of the patients had DVT whereas no PTE occurred during the period of the follow-up study. VDU examination is recommended for patients with acute stroke, which may help to diagnose and treat asymptomatic DVT early as well as prevent the subsequent incidence of PTE.
Literatur
1.
Zurück zum Zitat Kelly J, Rudd A, Lewis R, Hunt BJ (2001) Venous thromboembolism after acute stroke. Stroke 32(1):262–267PubMedCrossRef Kelly J, Rudd A, Lewis R, Hunt BJ (2001) Venous thromboembolism after acute stroke. Stroke 32(1):262–267PubMedCrossRef
2.
Zurück zum Zitat Kase CS, Albers GW, Bladin C et al (2009) Neurological outcomes in patients with ischemic stroke receiving enoxaparin or heparin for venous thromboembolism prophylaxis: subanalysis of the Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study. Stroke 40(11):3532–3540PubMedCrossRef Kase CS, Albers GW, Bladin C et al (2009) Neurological outcomes in patients with ischemic stroke receiving enoxaparin or heparin for venous thromboembolism prophylaxis: subanalysis of the Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study. Stroke 40(11):3532–3540PubMedCrossRef
3.
Zurück zum Zitat Lensing AW (1999) Anticoagulation in acute ischaemic stroke: deep vein thrombosis prevention and long-term stroke outcomes. Blood Coagul Fibrinolysis 10(Suppl 2):S123–S127PubMed Lensing AW (1999) Anticoagulation in acute ischaemic stroke: deep vein thrombosis prevention and long-term stroke outcomes. Blood Coagul Fibrinolysis 10(Suppl 2):S123–S127PubMed
4.
Zurück zum Zitat Sherman DG, Albers GW, Bladin C et al (2007) The efficacy and safety of enoxaparin versus unfractionated heparin for the prevention of venous thromboembolism after acute ischaemic stroke (PREVAIL Study): an open-label randomised comparison. Lancet 369(9570):1347–1355PubMedCrossRef Sherman DG, Albers GW, Bladin C et al (2007) The efficacy and safety of enoxaparin versus unfractionated heparin for the prevention of venous thromboembolism after acute ischaemic stroke (PREVAIL Study): an open-label randomised comparison. Lancet 369(9570):1347–1355PubMedCrossRef
5.
Zurück zum Zitat Bath PM, Lindenstrom E, Boysen G et al (2001) Tinzaparin in acute ischaemic stroke (TAIST): a randomised aspirin-controlled trial. Lancet 358(9283):702–710PubMedCrossRef Bath PM, Lindenstrom E, Boysen G et al (2001) Tinzaparin in acute ischaemic stroke (TAIST): a randomised aspirin-controlled trial. Lancet 358(9283):702–710PubMedCrossRef
6.
Zurück zum Zitat Brandstater ME, Roth EJ, Siebens HC (1992) Venous thromboembolism in stroke: literature review and implications for clinical practice. Arch Phys Med Rehabil 73(5-S):S379–S391PubMed Brandstater ME, Roth EJ, Siebens HC (1992) Venous thromboembolism in stroke: literature review and implications for clinical practice. Arch Phys Med Rehabil 73(5-S):S379–S391PubMed
7.
Zurück zum Zitat (1990) Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). The PIOPED Investigators. JAMA 263(20):2753-9 (1990) Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). The PIOPED Investigators. JAMA 263(20):2753-9
8.
Zurück zum Zitat Kelly J, Rudd A, Lewis RR et al (2004) Venous thromboembolism after acute ischemic stroke: a prospective study using magnetic resonance direct thrombus imaging. Stroke 35(10):2320–2325PubMedCrossRef Kelly J, Rudd A, Lewis RR et al (2004) Venous thromboembolism after acute ischemic stroke: a prospective study using magnetic resonance direct thrombus imaging. Stroke 35(10):2320–2325PubMedCrossRef
9.
Zurück zum Zitat Harvey RL, Roth EJ, Yarnold PR, Durham JR, Green D (1996) Deep vein thrombosis in stroke. The use of plasma D-dimer level as a screening test in the rehabilitation setting. Stroke 27(9):1516–1520PubMedCrossRef Harvey RL, Roth EJ, Yarnold PR, Durham JR, Green D (1996) Deep vein thrombosis in stroke. The use of plasma D-dimer level as a screening test in the rehabilitation setting. Stroke 27(9):1516–1520PubMedCrossRef
10.
Zurück zum Zitat Sun KK, Wang C, Pang BS et al (2004) Study on the risk factors of deep venous thrombosis in acute hospitalized stroke patients. Chin J Epidemiol 25(12):1019–1023 Sun KK, Wang C, Pang BS et al (2004) Study on the risk factors of deep venous thrombosis in acute hospitalized stroke patients. Chin J Epidemiol 25(12):1019–1023
11.
Zurück zum Zitat Han SW, Kim SH, Lee JY et al (2007) A new subtype classification of ischemic stroke based on treatment and etiologic mechanism. Eur Neurol 57(2):96–102PubMedCrossRef Han SW, Kim SH, Lee JY et al (2007) A new subtype classification of ischemic stroke based on treatment and etiologic mechanism. Eur Neurol 57(2):96–102PubMedCrossRef
12.
Zurück zum Zitat Guidelines-Writing-Group (2010) Chinese acute ischemic stroke management guideline. Chin Clin J Neurol 43(2):1–8 Guidelines-Writing-Group (2010) Chinese acute ischemic stroke management guideline. Chin Clin J Neurol 43(2):1–8
13.
Zurück zum Zitat Wang CJ, Huang CC, Yu PC, Chen HH (2004) Diagnosis of deep venous thrombosis after total knee arthroplasty: a comparison of ultrasound and venography studies. Chang Gung Med J 27(1):16–21PubMed Wang CJ, Huang CC, Yu PC, Chen HH (2004) Diagnosis of deep venous thrombosis after total knee arthroplasty: a comparison of ultrasound and venography studies. Chang Gung Med J 27(1):16–21PubMed
14.
Zurück zum Zitat Wells PS, Anderson DR, Bormanis J et al (1997) Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet 350(9094):1795–1798PubMedCrossRef Wells PS, Anderson DR, Bormanis J et al (1997) Value of assessment of pretest probability of deep-vein thrombosis in clinical management. Lancet 350(9094):1795–1798PubMedCrossRef
15.
Zurück zum Zitat Skaf E, Stein PD, Beemath A et al (2005) Venous thromboembolism in patients with ischemic and hemorrhagic stroke. Am J Cardiol 96(12):1731–1733PubMedCrossRef Skaf E, Stein PD, Beemath A et al (2005) Venous thromboembolism in patients with ischemic and hemorrhagic stroke. Am J Cardiol 96(12):1731–1733PubMedCrossRef
16.
Zurück zum Zitat McCarthy ST, Turner J (1986) Low-dose subcutaneous heparin in the prevention of deep-vein thrombosis and pulmonary emboli following acute stroke. Age Ageing 15(2):84–88PubMedCrossRef McCarthy ST, Turner J (1986) Low-dose subcutaneous heparin in the prevention of deep-vein thrombosis and pulmonary emboli following acute stroke. Age Ageing 15(2):84–88PubMedCrossRef
17.
Zurück zum Zitat Hull RD (2005) Revisiting the past strengthens the present: an evidence-based medicine approach for the diagnosis of deep venous thrombosis. Ann Intern Med 142(7):583–585PubMed Hull RD (2005) Revisiting the past strengthens the present: an evidence-based medicine approach for the diagnosis of deep venous thrombosis. Ann Intern Med 142(7):583–585PubMed
18.
Zurück zum Zitat Gathof BS, Picker SM, Rojo J (2004) Epidemiology, etiology and diagnosis of venous thrombosis. Eur J Med Res 9(3):95–103PubMed Gathof BS, Picker SM, Rojo J (2004) Epidemiology, etiology and diagnosis of venous thrombosis. Eur J Med Res 9(3):95–103PubMed
19.
Zurück zum Zitat White RH, McGahan JP, Daschbach MM, Hartling RP (1989) Diagnosis of deep-vein thrombosis using duplex ultrasound. Ann Intern Med 111(4):297–304PubMed White RH, McGahan JP, Daschbach MM, Hartling RP (1989) Diagnosis of deep-vein thrombosis using duplex ultrasound. Ann Intern Med 111(4):297–304PubMed
20.
Zurück zum Zitat Oger E, Leroyer C, Le Moigne E et al (1997) The value of a risk factor analysis in clinically suspected deep venous thrombosis. Respiration 64(5):326–330PubMedCrossRef Oger E, Leroyer C, Le Moigne E et al (1997) The value of a risk factor analysis in clinically suspected deep venous thrombosis. Respiration 64(5):326–330PubMedCrossRef
21.
Zurück zum Zitat Muir KW, Watt A, Baxter G, Grosset DG, Lees KR (2000) Randomized trial of graded compression stockings for prevention of deep-vein thrombosis after acute stroke. QJM 93(6):359–364PubMedCrossRef Muir KW, Watt A, Baxter G, Grosset DG, Lees KR (2000) Randomized trial of graded compression stockings for prevention of deep-vein thrombosis after acute stroke. QJM 93(6):359–364PubMedCrossRef
22.
Zurück zum Zitat Hara Y (2008) Deep venous thrombosis in stroke patients during rehabilitation phase. Keio J Med 57(4):196–204PubMedCrossRef Hara Y (2008) Deep venous thrombosis in stroke patients during rehabilitation phase. Keio J Med 57(4):196–204PubMedCrossRef
23.
Zurück zum Zitat Wein L, Wein S, Haas SJ, Shaw J, Krum H (2007) Pharmacological venous thromboembolism prophylaxis in hospitalized medical patients: a meta-analysis of randomized controlled trials. Arch Intern Med 167(14):1476–1486PubMedCrossRef Wein L, Wein S, Haas SJ, Shaw J, Krum H (2007) Pharmacological venous thromboembolism prophylaxis in hospitalized medical patients: a meta-analysis of randomized controlled trials. Arch Intern Med 167(14):1476–1486PubMedCrossRef
24.
Zurück zum Zitat Zheng H, Liu L, Sun H et al (2008) Prophylaxis of deep venous thrombosis and adherence to guideline recommendations among inpatients with acute stroke: results from a multicenter observational longitudinal study in China. Neurol Res 30(4):370–376PubMedCrossRef Zheng H, Liu L, Sun H et al (2008) Prophylaxis of deep venous thrombosis and adherence to guideline recommendations among inpatients with acute stroke: results from a multicenter observational longitudinal study in China. Neurol Res 30(4):370–376PubMedCrossRef
25.
Zurück zum Zitat White RH (2003) The epidemiology of venous thromboembolism. Circulation 107(23 Suppl 1):I4–I8PubMed White RH (2003) The epidemiology of venous thromboembolism. Circulation 107(23 Suppl 1):I4–I8PubMed
Metadaten
Titel
The incidence of venous thromboembolism following stroke and its risk factors in eastern China
verfasst von
Xingyang Yi
Jing Lin
Zhao Han
Xudong Zhou
Xiaotong Wang
Jiguang Lin
Publikationsdatum
01.08.2012
Verlag
Springer US
Erschienen in
Journal of Thrombosis and Thrombolysis / Ausgabe 2/2012
Print ISSN: 0929-5305
Elektronische ISSN: 1573-742X
DOI
https://doi.org/10.1007/s11239-012-0720-z

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