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Dehydration and venous thromboembolism after acute stroke
1Department of Elderly Care, Haematology and Chemical Pathology, Guy's and St. Thomas' Hospital Trust, London, UK. jameskelly@northbrookfm.fsnet.co.uk
Background:
Although it is widely assumed that dehydration predisposes to venous thromboembolism (VTE), there are no clinical studies to support this.
Aim:
To evaluate the relationship between biochemical indices of dehydration and VTE after acute ischaemic stroke (AIS).
Design:
Prospective observational study.
Methods:
Unselected AIS patients (n = 102) receiving standard thromboprophylaxis with aspirin and graded compression stockings, underwent serial measurements of serum urea, creatinine and osmolality, and were screened for VTE using magnetic resonance direct thrombus imaging.
Results:
Serum osmolality of >297 mOsm/kg, urea >7.5 mmol/l and urea:creatinine ratio (mmol:mmol) >80 a few days post-AIS were associated with odds ratios for VTE of, respectively, 4.7, 2.8 and 3.4 (p = 0.02, 0.05, 0.02) on multivariable analysis.
Discussion:
Dehydration after AIS is strongly independently associated with VTE, reinforcing the importance of maintaining adequate hydration in these patients.
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