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Deep Vein Thrombosis in Subacute Stroke Rehabilitation

Keywords: Stroke , Deep vein thrombosis , Doppler ultrasonography

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Abstract:

Deep vein thrombosis (DVT) is a major post-stroke complication that can lead to substantial morbidity and mortality. Following ethical approval, in-patients at the Rehabilitation Institute “Dr. Miroslav Zotovi ” Banja Luka with stroke (fi rst or recurrent) were recruited within 90 days of stroke onset, irrespective of the degree of neurological impairment. Compression Doppler ultrasound (DUS) of both lower extremities was performed within 48 hours of the patient’s admission to the rehabilitation unit. Th e biochemical indicator of hydration studied was serum urea in mmol/L. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) score. A total of 93 patients with an acute stroke underwent DVT screening during the study period, mean age was 64.8 years (SD 8.9), and 51 (54.83%) were male. Seventy-nine percent of strokes were ischemic. Th e prevalence of proximal DVT in stroke rehabilitation patients, using DUS as the diagnostic standard, was 11.82%. DVT of femoropopliteal (FP) veins occurred during rehabilitation period in 3 (3.22%) patients, 5 (5.37%) patients had symptomatic DVT and 3 (3.22%) asymptomatic DVT at admission to stroke rehabilitation. In the DVT group, 72.72% of strokes were ischemic and mean age was 68.2 (SD 9.4). Th e admission NIHSS score of the DVT group was higher than that of the non-DVT group (mean, 13.6 v 8.2). Mean serum urea in the non-DVT group was 7.3 (SD 3.2) and 6.9 (SD 2.9) mmol/l in the DVT group. DVT occurs most commonly among patients with severe stroke who have paralysis of the lower extremity and can develop in either an acute care or rehabilitation setting.

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