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Neurol Res. 2008 May;30(4):370-6. doi: 10.1179/174313208X300387.

Prophylaxis of deep venous thrombosis and adherence to guideline recommendations among inpatients with acute stroke: results from a multicenter observational longitudinal study in China.

Author information

1
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Abstract

INTRODUCTION:

Deep venous thrombosis (DVT) is a common complication in acute stroke. Evidence-based guidelines recommend the use of prophylactic heparins in patients with risk of DVT. We aimed to evaluate the clinical practices for DVT prophylaxis in acute stroke inpatients enrolled in a multicenter observational longitudinal study on deep venous thrombosis (Incidence of Deep Venous Thrombosis after Acute Stroke in China, INVENT-China).

MATERIALS AND METHODS:

Patients' characteristics and DVT prophylaxis was extracted from the database of INVENT-China. Appropriate adherence to the guidelines was analysed.

RESULTS:

Six hundred and fifty-six patients with acute stroke were eligible for analysis in this study. Pharmacologic prophylaxis with low-molecular-weight heparins (LMWH) was applied to 18 patients with ischemic stroke (3.4%) and one patient with cerebral hemorrhage. Independent factors associated with use of prophylactic anticoagulant treatment were stroke subtype (OR=0.07, 95% CI=0.01-0.78, p=0.03), baseline NIHSS score (OR=0.25, 95% CI=0.07-0.95, p=0.04), baseline motor leg function (NIHSS score) (score=1, OR=0.16, 95% CI=0.03-0.79, p=0.025; score=2, OR=0.20, 95% CI=0.05-0.84, p=0.028; score=3, OR=0.23, 95% CI=0.06-0.91, p=0.037; score=4, reference), diabetes mellitus (OR=3.86, 95% CI=1.39-10.72, p=0.009), malignancy (OR=9.55, 95% CI=1.98-46.2, p=0.005), varicose veins (OR=12.48, 95% CI=1.64-94.9, p=0.015) and central venous catheterization (OR=6.96, 95% CI=1.36-35.79, p=0.02).

CONCLUSION:

Thromboprophylaxis is inadequate in acute stroke inpatients in China. Guidelines for prevention DVT in acute stroke should be established and efforts should be made to improve venous thromboembolism prophylaxis practice.

PMID:
18544254
DOI:
10.1179/174313208X300387
[Indexed for MEDLINE]

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