Characteristics and risk factors of deep vein thrombosis in hemiplegic, healthy and bilateral limbs of hemiplegic patien
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Characteristics and risk factors of deep vein thrombosis in hemiplegic, healthy and bilateral limbs of hemiplegic patients: a 10-year retrospective study Feng Liang1 · Min Chao2 · Jue‑Bao Li1 · Xiang‑Ming Ye1 Accepted: 11 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Deep vein thrombosis (DVT) in hemiplegic patients mainly affects hemiplegic limbs, DVT can also occur only in healthy limbs, and some hemiplegic patients have DVT in both limbs. Characteristics and risk factors of DVT in hemiplegic, healthy, and bilateral limbs are unknown. To describe the proportion, risk factors, extent, and timing of DVT in hemiplegic, healthy and bilateral limbs. A 10-year retrospective review of consecutive patients was performed. DVT affected hemiplegic limbs in 34 (62%), healthy limbs in 11 (20%), and was bilateral in 10 (18%). DVT was more likely to develop in healthy limbs of hemiplegic patients without surgery (odds ratio (OR) 0.022; 95% confidence interval (CI) 0.001–0.922), and without diabetes (OR 0.023, 95% CI 0.001–0.853). Among the veins at the level of which DVT occurred, intermuscular veins represented 20 (45%) in hemiplegic, 5 (37%) in healthy, and 6 (74%) in bilateral limbs. The median time that DVT occurred after hemiplegia onset was 18 days (interquartile range [IQR] 9–79) in hemiplegic, 17 days (IQR 10–56) in healthy, and 21 days (IQR 8–27) in bilateral limbs. Early and effective prevention of DVT after surgery and optimal management of diabetes may reduce the risk of DVT in bilateral limbs. It’s important to prevent proximal extension of calf vein DVT. DVT prophylaxis should be started early and continued for at least 3 weeks after hemiplegia onset. Keywords Deep vein thrombosis · Hemiplegia · Hemiplegic limbs · Healthy limbs · Bilateral limbs · Retrospective study
Highlights • Characteristics and risk factors of DVT in hemiplegic,
healthy, and bilateral limbs are unknown.
the veins at the level of which DVT occurred most frequently. Most DVTs develop within 3 weeks after hemiplegia onset.
• A 10-year retrospective review of consecutive patients
Introduction
* Xiang‑Ming Ye [email protected]
Deep vein thrombosis (DVT) is a common complication in hemiplegic patients and may lead to the fatal consequences of a pulmonary embolism (PE) [1]. DVT mainly develops in the paralyzed limbs of hemiplegic patients, and DVT can also occur only in the healthy limbs, and some hemiplegic patients have DVT in both limbs. A study of 272 patients undergoing rehabilitation for cerebral infarction showed that most of the patients had distal DVT on the hemiparetic side, while others had bilateral DVT [2]. Another prospective study of patients with acute intracerebral hemorrhage (ICH) demonstrated that among the 19 ICH patients with paralysis, DVTs occurred on the paralytic side in 15, nonparalytic side in one, and both sides in three patients [3]. The CLOTS multicenter randomized trials analyzed data of
was performed. • The proportion of DVT in the healthy and bilateral limbs are very
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