Clinical Risk Factors of Asymptomatic Deep Venous Thrombosis in Patients With Acute Stroke

Deep venous thrombosis (DVT) is a common complication after stroke. It is easy to identify the patients with symptomatic DVT; however, the tool for asymptomatic high-risk population needs to be further explored. Our aim was to explore the risk factors of acute stroke patients with asymptomatic DVT.

We performed a prospective observation study among 452 patients with acute stroke who had a stroke within 14 days. Ultrasound examination of deep veins was repeatedly performed in each patient for DVT every 7 days during his admission. The dynamic rate of DVT in acute stroke was analyzed. Then risk factors were compared between DVT patients and non-DVT patients. The predictive model was explored based on thr cox proportion model.

Asymptomatic DVT was detected in 52 (11.5%) patients with stroke and 85.9% of thrombi were identified in their distal veins. Patients with longer length of stay (P = .004), more severe stroke (P = 0.001), higher level of D-dimer (P = .003), and higher blood glucose level were associated with higher risk of DVT, while patients with higher triglyceride level (P = .003) were less likely to have DVT, after adjusting age and sex. With the median of D-dimer (0.38 FEU mg/L) as cutoff value. Patients with higher level of D-dimer might have a higher risk of DVT with a significant statistical difference. Also, the severity of stroke differed DVT risk in Kaplan-Meier model. Using cox-proportion hazard regression model, asymptomatic DVT could be predicted (area under the curve 0.852).

Our data showed that asymptomatic DVT was common in patients with acute stroke and most of thrombosis occurred in distal veins. Combination of clinical manifestation and laboratory results might be helpful predict DVT. DVT prophylaxis should be condisdered in high risk.