Pambianco G, Orchard T, Landau P.
Deep vein thrombosis : prevention in stroke patients during rehabilitation.
Arch Phys Med Rehabil 1995 Apr;76(4):324-30

Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA, USA.

Deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) is a major source
of mortality and morbidity in stroke patients. This study was designed to
determine the effectiveness of different prophylactic treatments in the
prevention of DVT after a stroke in patients undergoing rehabilitation. An
additional objective was the identification of risk factors for DVT in stroke in
patients during rehabilitation. Three hundred and sixty patients, over a 3-year
period, were randomly assigned to one of four groups: adjusted dose heparin,
intermittent pneumatic compression (IPC), functional electrical stimulation
(FES), or control. There was no significant difference in the development of DVT
by treatment group. Patients with DVT on admission (prevalent, n = 61) were
compared with the study patients (n = 360). Time interval (from stroke to
admission) and lactic dehydrogenase (LDH) concentration were significant risk
factors, as well as predictors, for development of DVT (p < .000). These results
suggest that the longer a patient remains without DVT prophylaxis after a stroke,
the greater the risk of developing DVT and this supports early prophylaxis before
rehabilitation.