Journal of Neurocritical Care (대한신경집중치료학회지)

The Korean Neurocritical Care Society (대한신경집중치료학회)
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Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study

  • Ko, Keun Hyuk (Department of Neurology, Jeju National University School of Medicine) ;
  • Kang, Ji-Hoon (Department of Neurology, Jeju National University School of Medicine) ;
  • Kang, Sa-Yoon (Department of Neurology, Jeju National University School of Medicine) ;
  • Lee, Jung Seok (Department of Neurology, Jeju National University School of Medicine) ;
  • Song, Sook-Keun (Department of Neurology, Jeju National University School of Medicine) ;
  • Oh, Jung-Hwan (Department of Neurology, Jeju National University School of Medicine) ;
  • Kim, Joong-Goo (Department of Neurology, Jeju National University School of Medicine) ;
  • Han, Eun Young (Department of Rehabilitation Medicine, Jeju National University School of Medicine) ;
  • Lee, Ho Kyu (Department of Radiology, Jeju National University School of Medicine) ;
  • Choi, Jay Chol (Department of Neurology, Jeju National University School of Medicine)
  • Received : 2018.11.13
  • Accepted : 2018.12.18
  • Published : 2018.12.30
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Abstract

Background: A sians were known to have a relatively lower incidence of venous thromboembolism (VTE), and there is insufficient evidence to suggest a specific D-dimer threshold level for screening VTE in patients with acute stroke. Methods: We prospectively enrolled patients with acute ischemic stroke admitted to Jeju National University Hospital. The inclusion criteria were: 1) aged ${\geq}18$ years, 2) admission within seven days of symptom onset, and 3) an initial National Institute of Health Stroke Scale (NIHSS) score >1 for the affected lower limb. Ultrasound scans of the lower limbs and plasma D-dimer assays were performed on days 7-14 and 15-28 after stroke onset. Results: Of 285 patients admitted during the study period, 52 patients met inclusion criteria (mean age 74.5, male 40.4%, median initial NIHSS score 12, and unable to walk unassisted at discharge 76.9%). During 7-14 days, 23 of 52 patients (44.2%) had a D-dimer level above 1.57 mg/L, and 9.6% had a level above 5.50 mg/L. Proximal deep vein thrombosis (DVT) was detected in 3 patients (5.8%, 95% confidence Interval 1.2-16.0%) on ultrasound examination. All DVTs were found in elderly female patients with severe leg weakness. No patient was diagnosed with pulmonary embolism during the study period. Conclusion: The incidence of VTE seems to be very low among Korean patients with acute ischemic stroke. Advanced age, female sex, and severe leg weakness were important risk factors for developing DVT in this study.

Keywords

References

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