Prediction of deep vein thrombosis by ultrasonography and D-dimer in Asian patients with ischemic stroke.
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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.
SUBMITTER: Ha SH
PROVIDER: S-EPMC7320547 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
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