Deep venous thrombosis in patients with neurological diseases: A multicenter, prospective study

• Published in: Journal of clinical neuroscience 2021-09, Vol.91, p.214-218
• Main Authors: Nakajima, Makoto, Uyama, Eiichiro, Suga, Tomohiro, Honda, Shoji, Ando, Yukio
• Format: Article
• Language: English
• Subjects: Antithrombotic agent; Deep venous thrombosis; Neurological disease
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2021.07.007

•A multicenter study to investigate DVT in neurological diseases was conducted.•DVT was detected in over one fourth patients who had any DVT risk factors.•All the detected DVT was asymptomatic and prognosis was favorable.•Malignancy, decreased activity, and elevated D-dimer were predictors for DVT. Patients with neurological diseases are liable to develop deep venous thrombosis (DVT) due to various factors. We investigated the prevalence, related factors, and prognosis of DVT in patients with neurological diseases. Patients admitted to four hospitals due to neurological diseases were prospectively recruited. Those with cerebrovascular diseases were excluded. To screen for DVT, ultrasonography was performed in patients with possible DVT risk, such as D-dimer > 1.0 µg/dL, recent surgery, active malignant diseases, recent bone fracture, decreased activity, or treatment with immunoglobulin or steroid therapy. Clinical characteristics were compared between patients with and without DVT. A total of 106 patients (54 women, median 71 years old) were included. DVT was detected in 27 patients (26.0%) at the first assessment. All had DVT only in the calf; encephalopathy/meningitis (n = 4, 40.0%) had the highest prevalence of DVT among the underlying neurological diseases, followed by parkinsonian syndrome (n = 6, 37.5%). Independent predictors for DVT detection were malignant diseases (odds ratio, 11.7; 95% confidence interval, 1.0–301.4), modified Rankin Scale score ≥ 4 (5.4; 1.9–16.6), and D-dimer ≥ 2.0 µg/dL (5.7; 2.1–16.7). Ten patients were treated with anticoagulants, and no patients developed a symptomatic pulmonary embolism. No clinically evident pulmonary embolisms, systemic embolisms, or severe bleeding complications were observed in patients with DVT. Asymptomatic DVT is not rare in patients with neurological diseases, especially in those with malignancy, decreased activity, or elevated D-dimer. The overall prognosis is favorable, but the potential risk of development of a pulmonary embolism should be recognized.