Background

The mechanism of increased risk of venous thromboembolism (VTE) after acute ischemic stroke (AIS) is unclear. In this study, we aimed to evaluate the risk of VTE in hospitalizations due to AIS as compared to those due to non-vascular neurological conditions. We also aimed to assess any potential association between VTE risk and the use of intravenous thrombolysis (rtPA) among hospitalizations with AIS.

Materials and methods

In this case-control study, data were obtained from the Nationwide Inpatient Sample 2016-2018. Propensity score matching was used to adjust for the baseline differences between the groups. Logistic regression analysis was used to compare the risk of VTE.

Results

We identified 1,541,685 hospitalizations due to AIS and 1,453,520 hospitalizations due to non-vascular neurological diagnoses that served as controls. After propensity score matching, 640,560 cases with AIS and corresponding well-matched controls were obtained. Hospitalizations due to AIS had higher odds of VTE as compared to the controls [odds ratio (OR) 1.50, 95% confidence interval (CI) 1.40-1.60, P<0.001]. Among hospitalizations with AIS, 184,065 (11.9%) got rtPA. The odds of VTE were lower among the AIS hospitalizations that received rtPA as compared to those that did not (OR 0.89, 95% CI 0.79-0.99, P0.035).

Conclusion

Hospitalizations due to AIS have a higher risk of VTE as compared to the non-vascular neurological controls. Among AIS cases, the risk of VTE is lower among patients treated with rtPA. These epidemiological findings support the hypothesis that the risk of VTE after AIS might be partly mediated by an intrinsic pro-coagulant state.

中文翻译：

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急性缺血性卒中住院患者与其他神经系统疾病的静脉血栓栓塞风险

背景

急性缺血性卒中 (AIS) 后静脉血栓栓塞 (VTE) 风险增加的机制尚不清楚。在这项研究中，我们旨在评估与非血管性神经系统疾病相比，AIS 导致住院时 VTE 的风险。我们还旨在评估 AIS 住院期间 VTE 风险与静脉溶栓 (rtPA) 使用之间的任何潜在关联。

材料和方法

在这项病例对照研究中，数据来自 2016-2018 年全国住院患者样本。倾向得分匹配用于调整组之间的基线差异。逻辑回归分析用于比较 VTE 的风险。

结果

我们确定了 1,541,685 例 AIS 住院治疗和 1,453,520 例非血管神经系统诊断住院治疗作为对照。倾向得分匹配后，获得了 640,560 例 AIS 和相应的匹配良好的对照。与对照组相比，因 AIS 住院的 VTE 几率更高 [优势比 (OR) 1.50, 95% 置信区间 (CI) 1.40-1.60, P<0.001]。在 AIS 住院患者中，184,065 人（11.9%）接受了 rtPA。与未接受 rtPA 的 AIS 住院患者相比，接受 rtPA 的 AIS 住院患者发生 VTE 的几率较低（OR 0.89，95% CI 0.79-0.99，P = 0.035）。

结论

与非血管神经系统控制相比，因 AIS 住院的 VTE 风险更高。在 AIS 病例中，接受 rtPA 治疗的患者发生 VTE 的风险较低。这些流行病学研究结果支持这样的假设，即 AIS 后 VTE 的风险可能部分由内在的促凝状态介导。