[The prevalence of deep venous thrombosis in hospitalized patients with stroke].

OBJECTIVE: To investigate the prevalence and the clinical manifestations of DVT in hospitalized patients with acute stroke, and to evaluate the short-term prophylaxis effect of low molecular weight heparin (LMWH) to prevent DVT. METHODS: 488 cases with stroke admitted to the department of neurology and neurosurgery in Beijing Chaoyang Hospital between December 2001 and December 2002 were consecutively investigated. The diagnosis of stroke was identified by CT or MRI. The patients (95.5% Hans) were comprised of 328 male and 160 female, with a mean age of (65 +/- 11) years, ranging 22 approximately 93 years. The procedure of investigation: (1) A detailed history was taken and a physical examination was performed to every eligible patient. (2) The ultrasonography (US) was used for detecting both lower extremities at 7-10 days after acute stroke. (3) The ultrasound examination was repeated after a week in patients highly suspected of DVT. RESULTS: (1) The prevalence of DVT was 21.7% among the patients. (2) DVT was the most frequent (28.0%) in the patients ranging 70 approximately 79 years. (3) A higher incidence of DVT was observed in female than in male (29.4% vs 18.0%, P = 0.004). (4) The incidence of DVT in severely paralyzed patients was 25.9%. (5) Leg edema was the most common symptoms of DVT with the frequency of 13.3%, but there was a poor correlation between the symptoms and the location of DVT. And 74.5% patients were asymptomatic. (6) Most DVTs occurred in distal extremities. The DVTs in proximal veins and in distal veins were in a ratio of 1.0 to 2.3. Fibular veins were most frequently attacked (30.4%). The presence of a filling defect on ultrasound images was described in 77.3% of the DVTs. (7) A 40.0% reduction of DVT incidence was caused by LWMH treatment in ischemic stroke patients. CONCLUSIONS: (1) The hospitalized patients with acute stroke were the crowd with high risk of DVT. (2) Most DVTs were asymptomatic; the signs were nonspecific, which indicated the diagnosis of DVT couldn't depend merely on clinical manifestation. (3) Most DVTs were in distal extremities. Filling defect was the most common manifestation of ultrasonography in DVT. (4) The incidence of DVT could be reduced by using LMWH in acute ischemic stroke patients.

[Risk factors and clinical features of deep venous thrombosis: a report of 388 cases].

OBJECTIVE: To investigate the risk factors and clinical characteristics of deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE). METHOD: The clinical manifestations and risk factors in 388 patients with DVT were retrospectively studied. RESULTS: The ratio of DVT cases in hospitalized patients had a trend of increasing in recent years. 80.4% of the patients with DVT had risk factors. The most common risk factors were age over 40 years old (88.9%), heart disease (43.0%), hypertension (35.1%), long term immobilization (21.1%), and infection (20.1%). The most common clinical presentations of DVT were swelling (66.2%) and pain (40.5%) of the affected extremity. Calf swelling by more than or equal to 1 cm compared with the asymptomatic leg was found in 87.2% patients. The site of DVT was more common in left extremities and proximal veins. PTE was found in 34.5% of the DVT cases and 74.6% of them were diagnosed prior to DVT. The ratio of PTE caused by DVT didn't show significant difference between left and right legs, neither between proximal and distal veins. CONCLUSIONS: The ratio of DVT cases in hospitalized patients was increasing. Most patients with DVT had risk factors. DVT was usually asymptomatic before PTE was complicated.

[Study on the risk factors of deep venous thrombosis in acute hospitalized stroke patients].

OBJECTIVE: To identify the risk factors of deep venous thrombosis (DVT) in hospitalized patients with acute stroke, under a perspective case-control study. METHODS: 488 cases with stroke, identified by CT or MRI and admitted to the department of neurology and neurosurgery in Beijing Chaoyang Hospital between December 2001 and December 2002 were consecutively studied. There were 328 male and 160 female patients (95.5% Hans) with a mean age of 65 +/- 11 years, ranging 22 - 93 years. The procedure of study would include: (1) General condition, possible risk factors, symptoms of DVT physical check-up to every eligible patient on first day of admission but the plasma concentrations of D-dimer (ELISA), thrombomodulin, antithrombin-III and blood routine examination were measured on the next morning. (2) The ultrasonography (US) was used for detecting both lower extremities at 7 - 10 days after the onset of stroke, and D-dimer and AT-III tests were repeated on the same or next day that the US was taken. (3) The ultrasound examination was repeated after a week in patients with high suspicion of DVT. (4) The therapy of stroke was recorded before the end of the study. Data of stoke patients with DVT was compared with those without DVT to identify the DVT risk factors. The effect of each variable on DVT was assessed by logistic regression analysis. RESULTS: The prevalence of DVT was 21.7% among the patients. In multivariate analysis, age >/= 65 years old (OR = 1.655, 95% CI: 1.005 - 2.725), being male (OR = 1.993, 95% CI: 1.221 - 3.253), bedridden (OR = 3.275, 95% CI: 1.653 - 6.486) and DVT assessment scores >/= 2 (OR = 5.019, 95% CI: 2.685 - 9.381) were independently associated with DVT in all the stroke patients. Being male (OR = 2.828, 95% CI: 1.242 - 6.438), white blood cell count > 10.0 x 10(9)/L (OR = 2.032, 95% CI: 0.897 - 4.602) and DVT assessment scores >/= 2 (OR = 8.809, 95% CI: 3.081 - 25.188) were the independent risk factors of DVT in hemorrhagic stroke group. Age >/= 65 years old (OR = 2.167, 95% CI: 1.072 - 4.381), bedridden (OR = 3.008, 95% CI: 1.435 - 6.307) and DVT assessment scores >/= 2 (OR = 2.600, 95% CI: 1.077 - 6.278) were the independent risk factors of DVT in ischemic stroke group. CONCLUSION: Patients hospitalized with acute stroke were under high risk of DVT. Data suggested that old age, female, bedridden and high DVT assessment scores >/= 2 were independent risk factors for DVT in acute stroke patients that called for supervision and prophylaxis on DVT.