脑损伤康复期深静脉血栓形成的发病率及危险因素

来源 :世界核心医学期刊文摘(神经病学分册) | 被引量 : 0次 | 上传用户:ununszeto
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Objective: To determine the prevalence and risk factors of deep vein thrombosis (DVT) among neurorehabilitation admissions with acquired brain injury (BI). Methods: In this prospective, sequential case series, 709 consecutive initial neurorehabilitation patients with BI < 120 days including traumatic brain injury (TBI; n = 360), intracranial hemorrhage (ICH; n = 213), primary brain tumor (n = 66), and hypoxia/other BI (n = 70) were screened for evidence of DVT with lower extremity venous duplex ultrasonography (VDU). The admission screening protocol combine VDU and a commercial D dimer (Dimertest  ) latex agglutination assay. DVT was considered present based upon VDU results only. Results: DVT prevalence was 11.1% , and was higher with brain tumor (21.2% ) and ICH (16% ) than with TBI (6.7% ) (X2 test; p = 0.001). DVT risk factors identified by multivariable logistic regression analysis in the overall sample included older age (p = 0.002), type of BI (p = 0.04), DDLx (p = 0.0001), and greater post injury duration (p = 0.0001). with a trend observed regarding lower Functional Independence Measure (FIM) location (FIM Loco) subscale score (p = 0.07). However, risk factors also varied with type of BI. Among patients with TBI, only DDLx (p = 0.001) and greater post injury duration (p = 0.001) were associated with DVT. Conclusions: Admission venous duplex ultrasonography revealed occult proximal lower extremity deep vein thrombosis in 11% of neurorehabilitation patients with acquired brain injury. Deep vein thrombosis risk is multifactorial in this heterogenous patient population, with relative factor risk influenced by type of acquired brain injury. Semiquantitative D dimer latex agglutination assay correlated significantly with presence of deep vein thrombosis. Objective: To determine the prevalence and risk factors of deep vein thrombosis (DVT) among neurorehabilitation admissions with acquired brain injury (BI). Methods: In this prospective, sequential case series, 709 consecutive initial neurorehabilitation patients with BI <120 days including traumatic brain injury (TBI; n = 360), intracranial hemorrhage (ICH; n = 213), primary brain tumor (n = 66), and hypoxia / other BI (n = 70) were screened for evidence of DVT with lower extremity venous duplex ultrasonography (VDU). The admission screening protocol combined VDU and a commercial D dimer (Dimertest®) latex agglutination assay. DVT was considered present based upon VDU results only. Results: DVT prevalence was 11.1%, and was higher with brain tumor (21.2% (X2 test; p = 0.001). DVT risk factors identified by multivariable logistic regression analysis in the overall sample included older age (p = 0.002), type of BI (p = 0.04), DDLx (p = 0.0001), a nd greater post injury duration (p = 0.0001). with a trend observed regarding lower Functional Independence Measure (FIM) location (FIM Loco) subscale score (p = 0.07). However, risk factors also varied with type of BI. Among patients with Conclusions: Admission venous duplex ultrasonography revealed occult proximal lower extremity deep vein thrombosis in 11% of neurorehabilitation patients with acquired brain injury. Deep vein thrombosis risk is multifactorial in this heterogenous patient population, with relative factor risk influenced by type of acquired brain injury. Semiquantitative D dimer latex agglutination assay correlated significantly with presence of deep vein thrombosis.
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