Incidence and Risk Factors of Lower-Extremity Deep Vein Thrombosis After Thrombolysis Among Patients with Acute Ischemic Stroke

Abstract

Zhuo Liu,1,2 Dandan Liu,3 Zhen-Ni Guo,2 Hang Jin,2 Tong Sun,4 Chunping Ni,1,* Xiuli Yan2,* 1Fourth Military Medical University, School of Nursing, Xi’an, People’s Republic of China; 2Department of Neurology, The First Hospital of Jilin University, Changchun, People’s Republic of China; 3Physical Examination Center, The First Hospital of Jilin University, Changchun, People’s Republic of China; 4Cadre Ward, The First Hospital of Jilin University, Changchun, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiuli YanDepartment of Neurology, the First Hospital of Jilin University, 71# Xinmin Street, Changchun, 130021, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected] NiFourth Military Medical University, School of Nursing, 169# Changle Road West, Xi’an, 710032, People’s Republic of ChinaTel [phone]Fax [phone]Email [email protected]: Deep vein thrombosis (DVT) is common among patients with stroke. However, the incidence of DVT in acute ischemic stroke patients treated with thrombolytic therapy and the risk factors associated with this condition are unknown.Objective: This study aimed to investigate the incidence and risk factors of DVT after thrombolysis in patients with acute ischemic stroke.Settings and Methods: We retrospectively reviewed the medical records of all patients with acute ischemic stroke who underwent ultrasonic examination after intravenous thrombolysis between April 2017 and December 2019 at the stroke center of the First Hospital of Jilin University, China. Color duplex ultrasound was used to diagnosis DVT in all patients within 72 h after intravenous thrombolysis. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for DVT.Results: Overall, 474 patients were included in the study. Of these, 75 (15.8%) developed DVT (95% confidence interval 12.5– 19.1). Older age was the risk factor that most significantly affected the development of DVT (p = 0.001). Compared to patients younger than 60 years old, those aged 60– 69 years and ≥ 70 years had a higher risk of DVT, at rates of 2.201 (95% CI: 1.033– 4.689; p < 0.05) and 4.241 (95% CI: 2.016– 8.922; p < 0.001) times higher, respectively. Patients with higher triglyceride levels (odds ratio 0.545, 95% CI: 0.372– 0.799, p = 0.002) and longer activated partial thromboplastin time (OR 0.927, 95% CI: 0.862– 0.996, p = 0.040) were less likely to have DVT.Conclusion: DVT is a common complication among patients undergoing intravenous thrombolysis after acute ischemic stroke. Advanced age may increase the occurrence of DVT to some extent. For these patients, safe antiplatelet therapy should be explored and implemented as soon as possible.Keywords: acute ischemic stroke, deep vein thrombosis, incidence, risk factors, thrombolytic therapy

Keywords

• acute ischemic stroke
• deep vein thrombosis
• incidence
• risk factors
• thrombolytic therapy