INCIDENCE OF DEEP VENOUS THROMBOSIS IN STROKE PATIENTS IN MEDICAL INTENSIVE CARE UNIT ZAGAZIG UNIVERSITY HOSPITALS, EGYPT.

Abstract

Background and Purpose: Venous thromboembolism(VTE) is a leading cause of morbidity and mortality during the acute recovery period after stroke. This study was designed to study the incidence of deep venous thrombosis (DVT) in acute stroke patients & determine the risk factors contributing to development of DVT in these patients.
Patients &Methods: 280 patients, admitted because of acute stroke, were enrolled in this study. All patients were examined by Doppler ultrasonography (DUS) of the four limbs at one and two weeks after admission for possibility of DVT . If the patients was suspected to have DVT before or after this time (limb swelling, local pain or tenderness) DUS of the affected limb was done. We performed D-dimer assay level and considered it as an important marker for DVT suspicion. Other co-morbidities, type of stroke and their relation to DVT development were investigated. Data were collected, entered and checked using SPSS software version 17. Univariate and multivariate analysis of data were done to determine important predictor risk factors for DVT development in stroke patient
Results: 25 out of 280 patients(8.93%) developed DVT during their stay in intensive care unit (ICU) as a complication of acute stroke. DVT affected mainly the paralyzed limb and was mainly distal and occurred mostly after 2 weeks of admission. Patients complicated with DVT were characterized by being older and having higher percentage of smokers with no impact of gender. Multivariate regression analysis identified atrial fibrillation (AF) and intracerebral hemorrhage (ICH) as independent risk factors for early stroke related DVT (p=0.002 & p=0.025 respectively).
Conclusions: Incidence of DVT as a complication of stroke was 8.93 %. AF and ICH were determined as predictors and independent risk factors for development of DVT poststroke.
We recommend to follow the international guidelines for DVT prophylaxis .