Relative Risk of Deep Venous Thrombosis or Pulmonary Embolism Post-Stroke Based on Ambulatory Status

Abstract

During a 2-month rehabilitation hospital stay, 22 of 920 patients with stroke (2.4%) developed clinically significant venous thromboembolic (VTE) complications : nine deep venous thromboses (DVT), nine pulmonary emboli (PE), and four DVT and PE combined. Patients with VTE complications could be distinguished from 22 randomly selected controls by ambulatory status, presence of sensory deficit, and amount of motor recovery. The relative risk of VTE complications was estimated by odds ratio analysis with significance assessed using the Chi-square statistic. There was a fivefold reduction in relative risk of VTE complication once patients were able to walk 50 feet (15 m) irrespective of devices used or amount of therapist assistance required. There was a 12-fold reduction in relative risk once patients were able to ambulate away from a fixed hemibar irrespective of bracing requirements, use of a cane, or amount of therapist assistance needed. These data suggest that early ambulation at the hemibar using whatever bracing and/or therapist assistance required is associated with a significant reduction in VTE complication rate. Once patients are able to walk away from the hemibar, the risk of VTE complication is reduced still further, decreasing the need for subsequent VTE prophylaxis.

Keywords

Relative risk —Deep venous thrombosis —Pulmonary embolus —Stroke —Ambulatory status.

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