Prevalence and Risk Factors of Deep Vein Thrombosis with Acute Stroke: A Cross-sectional Study

Abstract

Background: Deep vein thrombosis (DVT) is a serious complication in stroke patients and may lead to the devastating consequences of a pulmonary embolism. The risk factors for DVT in acute stroke are advanced age, high National Institute of Health Stroke Scale (NIHSS) score, hemiparesis, immobility, female gender, atrial fibrillation. The present study is aimed at identifying the prevalence and risk factors for DVT in acute stroke patients. Methods: This was a prospective cross sectional study conducted in of Dhaka Medical College and Hospital from January 2022 to December 2023. Data was collected in a preformed questionnaire. Statistical analysis was performed using IBM SPSS version 26.0. Continuous variables were analyzed in the form of the means with standard deviations (Mean ± SD). Categorical variables were shown as numbers and proportions. Continuous data were analyzed using the independent samples t-test. Categorical data were analyzed using the chi-squared test. Univariate variables with a p-value of <0.05 were retained in a binary logistic regression model. Receiver operating characteristic (ROC) curve analysis was performed by identifying the area under the ROC curve (AUC) to evaluate the performance of the logistic regression model. Statistical significance was defined as a p-value of < 0.05. Results: A total of 106 patients with acute stroke (AS) were included in the study. The included patients were divided into two groups: DVT and non-DVT group. Out of 106 patients, 34(32.07%) patients presented with DVT. Patients with DVT were older than those without DVT (62.7 ± 10.7 vs. 56.5 ± 11.9 years, p < 0.05). Females were more affected by DVT (58.88% vs. 26.85%, p<0.05). In the DVT group, the level of D-dimer was significantly higher than that in the non- DVT group (2.2 ± 1.7 vs. 0.45 ± 1.1, p < 0.05). Elevated CRP and low serum albumin level were also observed in DVT group which was statistically significant. (p<0.05). Multiple logistic regression analysis showed that age>60years, NIHSS score>25 and a D-dimer level of ≥ 1.52 μg/mL and caprine score >6 were independent factors for the presence of DVT at the time of stroke admission. Odds ratio for age, Caprini RAM score, NIHSS score and elevated d-dimer were 1.043(1.000–1.075, p=0.029),1.43(0.85-0.1.96, p=0.001),1.266(1.168-1.284, p=0.008) and1.446 (1.130–1.849, p=0.003) respectively. Conclusion: The present study has showed that advanced age, high NIHSS and caprini score and raised serum D-dimer levels are independent predictors of DVT in stroke patients. A further large multicenter study should be done to provide a better management to the patients of DVT in stroke patients.