Risk of Venous Thromboembolism in Hospitalized Patients with Acute Ischemic Stroke Versus Other Neurological Conditions |
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| Affiliation: | 1. Department of Neurology, Division of Cerebrovascular Diseases, University of Iowa, Iowa City, Iowa, USA;2. Department of Internal Medicine, Division of Hematology/Oncology, University of Iowa, Iowa City, Iowa, USA.;3. Department of Neurosurgery, University of Iowa, Iowa City, Iowa, USA;4. Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA;1. Department of Neurosurgery, Brigham and Women''s Hospital, 60 Fenwood Road, Boston, MA 02120, United States;2. Department of Neurocritical Care, Brigham and Women''s Hospital, 60 Fenwood Road, Boston, MA 02120, United States;1. Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy;2. Pediatric Clinic, Pietro Barilla Children''s Hospital, University of Parma, Italy;1. Department of Neurology, Seoul St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea;2. Department of Neurology, St. Vincent''s Hospital, College of Medicine, The Catholic University of Korea, 93, Jungbu-daero, Paldal-gu, Suwon-si, Gyeonggi-do, Republic of Korea |
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| Abstract: | BackgroundThe mechanism of increased risk of venous thromboembolism (VTE) after acute ischemic stroke (AIS) is unclear. In this study, we aimed to evaluate the risk of VTE in hospitalizations due to AIS as compared to those due to non-vascular neurological conditions. We also aimed to assess any potential association between VTE risk and the use of intravenous thrombolysis (rtPA) among hospitalizations with AIS.Materials and methodsIn this case-control study, data were obtained from the Nationwide Inpatient Sample 2016-2018. Propensity score matching was used to adjust for the baseline differences between the groups. Logistic regression analysis was used to compare the risk of VTE.ResultsWe identified 1,541,685 hospitalizations due to AIS and 1,453,520 hospitalizations due to non-vascular neurological diagnoses that served as controls. After propensity score matching, 640,560 cases with AIS and corresponding well-matched controls were obtained. Hospitalizations due to AIS had higher odds of VTE as compared to the controls [odds ratio (OR) 1.50, 95% confidence interval (CI) 1.40-1.60, P<0.001]. Among hospitalizations with AIS, 184,065 (11.9%) got rtPA. The odds of VTE were lower among the AIS hospitalizations that received rtPA as compared to those that did not (OR 0.89, 95% CI 0.79-0.99, P0.035).ConclusionHospitalizations due to AIS have a higher risk of VTE as compared to the non-vascular neurological controls. Among AIS cases, the risk of VTE is lower among patients treated with rtPA. These epidemiological findings support the hypothesis that the risk of VTE after AIS might be partly mediated by an intrinsic pro-coagulant state. |
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