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Prevalence of Venous Thromboembolism in Acute Hemorrhagic and Thromboembolic Stroke

Gregory, Patricia C. MD; Kuhlemeier, Keith V. PhD, MPH

American Journal of Physical Medicine & Rehabilitation: May 2003 - Volume 82 - Issue 5 - p 364-369
doi: 10.1097/01.PHM.0000064725.62897.A5
Research Article: Stroke

Gregory PC, Kuhlemeier KV: Prevalence of venous thromboembolism in acute hemorrhagic and thromboembolic stroke. Am J Phys Med Rehabil 2003;82:364–369.

Objective Deep venous thromboembolism (DVT) is an important health issue in the hospitalized geriatric population that leads to increased length of stay, morbidity, and mortality. Patients with hemorrhagic strokes are usually not placed on prophylactic therapy because of the risk of hemorrhagic extension of the stroke. The purpose of this study was to evaluate the prevalence of DVTs in hospitalized patients with hemorrhagic vs. thromboembolic strokes.

Design Retrospective chart review of data obtained from the Maryland Health Services Cost Review Commission data base for 1999 to determine the prevalence of DVTs in both hemorrhagic and thromboembolic stroke patients hospitalized acutely. Multiple logistic regression was performed to evaluate possible risk factors.

Results There were 1,926 patients hospitalized with a primary diagnosis of hemorrhagic stroke and 15,599 with thromboembolic stroke. Women in general had more strokes than men did. Older patients were more likely to have strokes as evidenced by the mean ages of 66 and 71 yr for hemorrhagic and thromboembolic strokes, respectively. A total of 37 patients (1.9%) with hemorrhagic strokes had DVTs, whereas 74 patients (0.5%) with thromboembolic strokes had DVTs. Hemorrhagic stroke was an independent risk factor for DVT (odds ratio, 2.60; 95% confidence interval, 1.49–4.55;P = 0.0008).

Conclusions DVT prevalence and risk was higher among patients with hemorrhagic strokes in comparison with patients with thromboembolic strokes.

From the Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Presented at the Annual Rehabilitation Update, Park City, UT, January 2001.

All correspondence and requests for reprints should be addressed to Patricia C. Gregory, MD, The Johns Hopkins University School of Medicine, Department of Physical Medicine and Rehabilitation, 5601 Loch Raven Boulevard, Professional Building Suite 406, Baltimore, MD 21239.

© 2003 Lippincott Williams & Wilkins, Inc.