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. 2020 Jun 27;20(1):257.
doi: 10.1186/s12883-020-01842-w.

Prediction of deep vein thrombosis by ultrasonography and D-dimer in Asian patients with ischemic stroke

Sang Hee Ha  1 , Yeon-Jung Kim  2 , Sung Hyuk Heo  1 , Dae-Il Chang  1 , Bum Joon Kim  3
Affiliations

Prediction of deep vein thrombosis by ultrasonography and D-dimer in Asian patients with ischemic stroke

Sang Hee Ha et al. BMC Neurol. .

Abstract

Background: Deep vein thrombosis (DVT) is an important complication of ischemic stroke, although the incidence of DVT is regarded as being lower in Asian than in non-Asian patients. Here, we investigated the incidence and factors associated with DVT in Asian patients with ischemic stroke.

Methods: Acute ischemic stroke patients received lower extremity ultrasonography (LEUS) to diagnose the presence of DVT. Clinical characteristics and laboratory results, including D-dimer level, were compared between patients with and without DVT. Independent risk factors for DVT were investigated using multivariable analysis. Similar analysis was performed to identify factors associated with elevated D-dimer level (> 0.5 mg/dl) in acute ischemic stroke patients.

Results: During the study period, 289 patients were enrolled, and 38 (13.1%) showed DVT. Female sex (OR = 2.579, 95% CI = 1.224-5.432; p = 0.013) and a high National Institutes of Health Stroke Scale (NIHSS) score (OR = 1.191 95% CI = 1.095-1.294; p = 0.005) were independently associated with the presence of DVT, although D-dimer level was not. Stroke mechanism, especially cardioembolic stroke (OR = 3.777, 95% CI = 1.532-9.313; p = 0.004; reference: large artery atherosclerosis), NIHSS score (OR = 1.087, 95% CI = 1.002-1.179; p = 0.001) and thrombolysis (OR = 12.360, 95% CI 2.456-62.213; p = 0.002) were independently associated with elevated abnormal D-dimer levels.

Conclusion: The severity of ischemic stroke, but not the D-dimer level, was associated with the presence of DVT in Asian ischemic stroke patients. D-dimer level was influenced by the stroke mechanism. LEUS in patients with severe neurological deficit, rather than screening with D-dimer, may be more beneficial for diagnosing DVT in Asian patients with acute ischemic stroke.

Keywords: D-dimer; Deep vein thrombosis; Ischemic stroke; Ultrasonography.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Initial NIHSS according to the presence of DVT (a) and D-dimer level according to stroke mechanism (b). DVT: deep vein thrombosis, NIHSS: National Institute of Health Stroke Scale, LAA: large artery atherosclerosis, SVO: small vessel occlusion, CE: cardioembolism, OD: other determined, UD: undetermined
See this image and copyright information in PMC

References

    1. Sioson ER. Deep vein thrombosis in stroke patients: An overview. J Stroke Cerebrovasc Dis. 1992;2(2):74–79. doi: 10.1016/S1052-3057(10)80209-5. - DOI - PubMed
    1. Bounds JV, Wiebers DO, Whisnant JP, Okazaki H. Mechanisms and timing of deaths from cerebral infarction. Stroke. 1981;12(4):474–477. doi: 10.1161/01.str.12.4.474. - DOI - PubMed
    1. Bronnum-Hansen H, Davidsen M, Thorvaldsen P, Danish MSG. Long-term survival and causes of death after stroke. Stroke. 2001;32(9):2131–2136. doi: 10.1161/hs0901.094253. - DOI - PubMed
    1. Bembenek J, Karlinski M, Kobayashi A, Czlonkowska A. Early stroke-related deep venous thrombosis: risk factors and influence on outcome. J Thromb Thrombolysis. 2011;32(1):96–102. doi: 10.1007/s11239-010-0548-3. - DOI - PMC - PubMed
    1. Khan MT, Ikram A, Saeed O, Afridi T, Sila CA, Smith MS, et al. Deep Vein Thrombosis in Acute Stroke - A Systemic Review of the Literature. Cureus. 2017;9(12):e1982. doi: 10.7759/cureus.1982. - DOI - PMC - PubMed

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