Abstract T MP94: Venous Thromboembolism Complications In Patients With Intracerebral Hemorrhage

Stroke(2015)

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摘要
Introduction: Intracerebral hemorrhage (ICH) is often more severe than ischemic stroke. Venous thromboembolism (VTE), such as deep vein thrombosis (DVT) and pulmonary embolism (PE) can extend length of stay and impede recovery. For ICH patients, there is the added challenge of timing and dosage of anticoagulation used to prevent VTEs. We sought to describe the rate of VTE and factors associated with it among ICH cases in a multi-ethnic population. Methods: ERICH is a multi-center, prospective case-control study of ICH among white, black, and Hispanic patients. Data were collected by hospital chart review and personal interview. CT Images were collected and analyzed by a neuroimaging core. Past medical history and acute clinical data were examined for association with VTE during the hospital stay. Results: Between 8/1/10 and 12/31/13, 2276 cases of ICH were enrolled. CT data are available for 2038 patients. Of these, 63 had VTE complications: 41-DVT, 16-PE, and 6 - both DVT and PE. In univariate analysis, Blacks, previous history of DVT, low GCS at presentation, increased ICH volume, presence of intraventricular hemorrhage (IVH),and need for intubation. In comparison, patients at higher risk for PE were those with past medical history of PE and required intubation (Table). In addition, patients with DVT and PE had higher modified Rankin Scale at both hospital discharge and 3 months. In multivariate analysis, only previous VTE, the need for intubation and the presence of IVH were associated with DVT or PE. Conclusion: We confirmed within a large and ethnically diverse ICH patient population that clinically diagnosed VTE events are relatively rare at 3%. The strongest risk factor for development of DVT/PE was a prior history of DVT/PE. But the most prevalent risk factor was a need for intubation. Further study is needed to understand the efficacy of VTE preventative strategies among ICH patients.
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