%0 Journal Article
%T Rate of deep-vein thrombosis and pulmonary embolism during the care continuum in patients with acute ischemic stroke in the United States
%A Amin Alpesh N
%A Lin Jay
%A Thompson Stephen
%A Wiederkehr Daniel
%J BMC Neurology
%D 2013
%I BioMed Central
%R 10.1186/1471-2377-13-17
%X Background Deep-vein thrombosis (DVT) and pulmonary embolism (PE) are frequent and life-threatening complications of ischemic stroke. We evaluated rates of symptomatic DVT/PE, and of in-hospital and post-discharge thromboprophylaxis in patients with acute ischemic stroke (AIS). Methods In a retrospective US database analysis, data were extracted from the Premier Perspective -i3 Pharma Informatics linked database for patients aged ¡Ý18 years who were hospitalized for ischemic stroke from January 2005 to November 2007, and who had ¡Ý6 months¡¯ continuous plan enrollment prior to index hospitalization. Patients discharged to an acute-care facility or with atrial fibrillation were excluded. Prophylaxis was evaluated during index hospitalization and for 14 days¡¯ post-discharge. DVT/PE rates were calculated during index hospitalization and up to 30 days post-discharge. Results A total of 1524 patients were included; 46.1% received pharmacological and/or mechanical prophylaxis in-hospital (28.3%, 11.4% and 12.3% received unfractionated heparin, enoxaparin and mechanical prophylaxis, respectively). 6.4% of patients received outpatient pharmacological prophylaxis; warfarin was most frequently prescribed (5.9%). Total mean ¡À standard deviation length of index hospitalization was 3.0 ¡À 2.5 days. Mean prophylaxis duration in all patients was 0.9 ¡À 1.5 days in-hospital and 1.7 ¡À 6.9 days post-discharge. Symptomatic DVT/PE occurred in 25 patients overall (1.64%), with an inpatient rate of 0.98% and an outpatient rate of 0.66%. Conclusions Approximately 1% of patients with AIS experienced symptomatic in-hospital and/or post-discharge DVT/PE. Although 46% received prophylaxis in-hospital, only 6% received prophylaxis in the outpatient setting. This highlights the need for sustained thromboprophylaxis prescribing across the continuum of care.
%K Acute ischemic stroke
%K Care continuum
%K Deep-vein thrombosis
%K Pulmonary embolism
%K Thromboprophylaxis
%U http://www.biomedcentral.com/1471-2377/13/17