KMID : 1201420180110020102
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Journal of Neurocritical Care 2018 Volume.11 No. 2 p.102 ~ p.109
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Venous Thromboembolism Following Acute Ischemic Stroke: A Prospective Incidence Study
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Ko Keun-Hyuk
Kang Ji-Hoon Kang Sa-Yoon Lee Jung-Seok Song Sook-Keun Oh Jung-Hwan Kim Joong-Goo Han Eun-Young Lee Ho-Kyu Choi Jay-Chol
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Abstract
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Background: Asians 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 ¡Ã18 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.
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KEYWORD
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Venous thromboembolism, Stroke, Venous thrombosis
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