Objective: To investigate the prevalence and the clinical manifestations of DVT in hospitalized patients with acute stroke, and to evaluate the short-term prophylaxis effect of low molecular weight heparin (LMWH) to prevent DVT.
Methods: 488 cases with stroke admitted to the department of neurology and neurosurgery in Beijing Chaoyang Hospital between December 2001 and December 2002 were consecutively investigated. The diagnosis of stroke was identified by CT or MRI. The patients (95.5% Hans) were comprised of 328 male and 160 female, with a mean age of (65 +/- 11) years, ranging 22 approximately 93 years. The procedure of investigation: (1) A detailed history was taken and a physical examination was performed to every eligible patient. (2) The ultrasonography (US) was used for detecting both lower extremities at 7-10 days after acute stroke. (3) The ultrasound examination was repeated after a week in patients highly suspected of DVT.
Results: (1) The prevalence of DVT was 21.7% among the patients. (2) DVT was the most frequent (28.0%) in the patients ranging 70 approximately 79 years. (3) A higher incidence of DVT was observed in female than in male (29.4% vs 18.0%, P = 0.004). (4) The incidence of DVT in severely paralyzed patients was 25.9%. (5) Leg edema was the most common symptoms of DVT with the frequency of 13.3%, but there was a poor correlation between the symptoms and the location of DVT. And 74.5% patients were asymptomatic. (6) Most DVTs occurred in distal extremities. The DVTs in proximal veins and in distal veins were in a ratio of 1.0 to 2.3. Fibular veins were most frequently attacked (30.4%). The presence of a filling defect on ultrasound images was described in 77.3% of the DVTs. (7) A 40.0% reduction of DVT incidence was caused by LWMH treatment in ischemic stroke patients.
Conclusions: (1) The hospitalized patients with acute stroke were the crowd with high risk of DVT. (2) Most DVTs were asymptomatic; the signs were nonspecific, which indicated the diagnosis of DVT couldn't depend merely on clinical manifestation. (3) Most DVTs were in distal extremities. Filling defect was the most common manifestation of ultrasonography in DVT. (4) The incidence of DVT could be reduced by using LMWH in acute ischemic stroke patients.