scholarly journals Frequency of deep vein thrombosis at admission for acute stroke and associated factors: a cross-sectional study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Takahisa Mori ◽  
Kazuhiro Yoshioka ◽  
Yuhei Tanno

Abstract Background Intermittent pneumatic compression (IPC) is commonly used to prevent deep vein thrombosis (DVT) during hospitalization in patients with acute stroke. However, if DVT exists at admission, IPC of the legs with DVT may cause migration of the thrombi, resulting in pulmonary emboli. Whole-leg ultrasonography (wl-US) is a practical tool to detect DVT; however, wl-US is not always performed at admission in all stroke patients. This retrospective cross-sectional study aimed to investigate DVT frequency and identify significant factors indicating the presence of DVT at admission for acute stroke. Methods We included patients admitted within 24 h of stroke onset between 2017 and 2019. Patients who did not undergo blood tests for D-dimer or wl-US within 72 h of arrival were excluded. We collected patient data on age; sex; anthropometric variables; presence of DVT on wl-US; and biomarkers such as D-dimer, high-sensitivity C-reactive protein (hs-CRP), and lipids. Results Of 1129 acute stroke patients, 917 met our inclusion criteria. DVT was detected in 161 patients (17.6 %). Patients with DVT were older; were more likely to be female; had lower body weight; had higher D-dimer and hs-CRP levels; had lower albumin, hemoglobin, and triglyceride levels; and had higher National Institutes of Health Stroke Scale and pre-stroke modified Rankin scale scores than patients without DVT (n = 756). In addition, multiple logistic regression analysis showed that sex (female) and D-dimer levels (≥ 1.52 µg/mL) were independent significant factors for the presence of DVT. Among 161 patients with DVT, 78 (48.4 %) had both these significant factors. Among 756 patients without DVT, 602 (79.6 %) had no or one significant factor. The odds ratio of the presence of DVT in patients with both significant factors was 6.29, using patients without any significant factors as the group for comparison. Conclusions The frequency of DVT is high in acute stroke patients at admission. Female sex and a high D-dimer level were independent significant factors for the presence of DVT. Therefore, in patients with these two significant factors at admission, IPC should be avoided or wl-US should be performed before IPC.

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yared Zenebe Zewde ◽  
Abenet Tafesse Mengesha ◽  
Yeweynhareg Feleke Gebreyes ◽  
Halvor Naess

Abstract Background Admission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting. Methods A prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 h of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as > 140 mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively. Results A total of 103 first-ever acute stroke patients were included (mean age = 55.5 + 15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10–19) compared to normoglycemic patients 11 (IQR 8–15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99–6.19) more likely to be functionally impaired (mRS = 3–5) at 30-days compared to normoglycemic patients (P = 0.041).Older age (≥ 65 years) (P = 0.017) and stroke severity (NIHSS > 14) (P = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association. Conclusions Hyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-day of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.


2010 ◽  
Vol 72 (4) ◽  
pp. 323-326 ◽  
Author(s):  
Gautam V. Kamat ◽  
S. C. Metgud ◽  
Vishwanath M. Pattanshetti ◽  
A. S. Godhi

2019 ◽  
Author(s):  
Yared Zenebe Zewde ◽  
Abenet Tafesse Mengesha ◽  
Yeweyenhareg Feleke Gebreyes ◽  
Halvor Naess

Abstract Background: Admission hyperglycemia (HG) has been associated with worse outcomes among acute stroke patients. A better understanding and awareness of the potentially adverse influence of hyperglycemia on the clinical outcome of acute stroke patients would help to provide guidance for acute stroke management and prevention of its adverse outcomes. We aimed to assess the frequency of admission hyperglycemia and its impact on short term (30-days) morbidity and mortality outcomes of stroke in adult Ethiopian patients in an urban setting.Methods: A prospective, cross-sectional study was conducted among acute stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH), within 72 hours of symptom onset, from July to December 2016. Socio-demographic data, neuroimaging findings and capillary blood glucose values were obtained on admission. Hyperglycemia was defined as >140mg/dl. National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the baseline stroke severity and the 30-days post-stroke outcome, respectively.Results: A total of 103 first-ever acute stroke patients were included (mean age = 55.5+15.3 years, 64.1% male and 65% under the age of 65 years) and 51 (49.5%) were hyperglycemic at time of admission. The median admission NIHSS score was worse in the hyperglycemic patients 14 (IQR 10-19) compared to normoglycemic patients 11 (IQR 8-15). Among stroke survivors, patients with hyperglycemia were 3.83 times (95% CI, 1.99-6.19) more likely to be functionally impaired (mRS = 3-5) at 30-days compared to normoglycemic patients (p = 0.041).Older age (≥ 65 years) (p = 0.017) and stroke severity (NIHSS >14) (p = 0.006) at admission were both significantly associated with poor functional recovery at 30-day. Among the patients who died at 30-day, two-third (66.7%) were hyperglycemic but they failed to show any significant association.Conclusions: Hyperglycemia is prevalent among Ethiopian stroke patients at the time of presentation and it is associated with significantly poor functional recovery at 30th-days of follow up. This finding provides a rationale for achieving normal blood glucose in the course of acute stroke management which could have a favorable impact on the neurological outcome and quality of life for patients.


2018 ◽  
Vol 14 (1) ◽  
pp. 71-80
Author(s):  
Destika Fahrina ◽  
Puji Pinta Sinurat ◽  
Aldy Sjarifuddin Rambe

Currently, there were only a few studies regarding the correlation between concentration of creatine kinase-myocardial band (CKMB), troponin T, hemoglobin, and electrolytes and acute stroke. This study aimed to understand the difference of mean concentration of CKMB, troponin T, hemoglobin, and electrolytes and their relationship with acute stroke. This was a cross sectional study using samples of 30 subjects who were selected with consecutive non random sampling. The subjects were acquired from acute stroke patients who were proven clinically and using computed tomography (CT) scan at Haji Adam Malik General Hospital. Demographic data were analyzed using descriptive statistic. The result showed that there were no difference in demographical characteristics between the subjects. In conclusion, there were no differences in mean of CKMB, troponin T, hemoglobin, and electrolytes in acute stroke. No correlation was found between acute stroke and concentration of CKMB, troponin T, hemoglobin, and electrolytes.


2020 ◽  
Vol 15 (8) ◽  
pp. 1425-1433 ◽  
Author(s):  
Matteo Giorgi-Pierfranceschi ◽  
Oriana Paoletti ◽  
Angelo Pan ◽  
Fabio De Gennaro ◽  
Anna Laura Nardecchia ◽  
...  

2020 ◽  
Vol 22 (7) ◽  
Author(s):  
Pir-Hossein Kolivand ◽  
Hassanali Faraji Sabokbar ◽  
Peyman Saberian ◽  
Mahdi Bahmanabadi ◽  
Parisa Hasani-Sharamin ◽  
...  

Objectives: We intended to map the geographical distribution of patients with acute stroke who called the Tehran EMS center based on the geographic information of the incident location on a map. The distributions of these centers and patients’ access within a standard period were evaluated. Methods: A cross-sectional study based on the registered data was conducted on suspected acute stroke patients > 18 years of age that were transferred by EMS. The analysis was performed based on pointing the patients’ locations and locating the hospitals in ArcGIS software plus a review of the polygons and focal points. Results: Totally, 1,606 patients suspected to stroke with a mean age of 64.89 ± 17.48 years were evaluated, of whom 947 (58.6%) were male. The mean time of arrival of an ambulance in the patient’s location from the EMS station was 11.94 ± 6.67 minutes, and the longest time was 69.32 minutes. The mean time from the patient’s location to the stroke center was 17.79 ± 11.42 minutes (range 2.4 - 83.70 minutes). Stroke centers in Tehran are not distributed in a balanced manner, and they are concentrated on the central and northern parts of Tehran, limiting access to hospital services. Conclusions: The multiplicity of hospitals in the west and center of Tehran led to an increase in access times in eastern Tehran. It emphasizes the necessity of revision of service locating, especially because the east of Tehran has a denser texture than the west.


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