Introduction: Deep venous thrombosis (DVT) is thought to be less common in Asians than in the Caucasian population. The incidence of asymptomatic DVT in high-risk groups in the Asian population has not been well studied. While DVT incidence among Caucasian stroke patients has been extensively studied and the need for prophylaxis established, the lack of data in Asian patients leaves physicians with no firm basis for adopting prophylactic protocols in the local population. Our aim was to prospectively establish the incidence of early DVT in immobilised stroke patients in a heterogenous Asian population. Materials and Methods: We screened 44 patients with significant hemiplegia from acute stroke. Doppler ultrasound, the currently accepted method of investigation for DVT, was used to study patients on admission and at 1 week post-stroke. While there was no standard prophylactic regime in use, none of the patients received heparin and only 2 were given compression stockings. Results: The incidence of DVT at 1 week was 2.4%. Review at 1 month detected another patient with DVT, bringing the overall incidence at 1 month to 4.8%. This is lower than in Caucasian populations, but is similar to another local study on a different group of high-risk patients. Conclusion: The low incidence of early DVT in hospitalised stroke patients of Asian ethnicity does not justify routine screening for this population. Further research to validate this should ideally include a comparison test for DVT as ultrasound may have inherently lower sensitivity in an asymptomatic population.
Deep venous thrombosis (DVT) is part of the spectrum of venous thromboembolism (VTE), with thrombi in the limbs predisposing to pulmonary embolism (PE). Immobility is an important risk factor for VTE, and patients with reduced mobility from a wide variety of causes are particularly vulnerable.1 In stroke patients, PE is the most common cause of death between the second and fourth weeks.2 DVT is often asymptomatic;3 PE may occur without clinical signs.4 It is therefore important to detect and treat occult DVT.
This article is available only as a PDF. Please click on “Download PDF” to view the full article.