Analysis of the effect of deep vein thrombosis and venous thromboembolic complications on the rehabilitation potential of stroke patients

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Introduction. Rehabilitation after stroke and the presence of concomitant factors affecting the course of stroke are urgent issues of our time. One of these factors is deep vein thrombosis (DVT) and venous thromboembolic complications (VTE). Many studies [1, 2] have highlighted the importance of early diagnosis of DVT and VTE when a stroke patient is admitted to a hospital, and early initiation of rehabilitation measures. We decided to conduct our own study of stroke patients who were diagnosed with DVT and VTE.

The aim of the work is to analyze the effect of DVT and VTE on the rehabilitation potential of stroke patients.

Materials and methods of research. We retrospectively examined the medical records of 12 stroke patients aged 52 to 86 years, 10 female and 2 male patients. There were 3 patients with ischemic stroke and 9 patients with hemorrhagic stroke. Factors such as the severity of stroke at the onset were studied (a sample of patients with NIHSS of 5-18 points at admission was made), the presence of previous neurological deficits, comorbidity, nutritional insufficiency and venous thromboembolic complications. In this study, we analyzed the effect of deep vein thrombosis and VTE on the rehabilitation potential of stroke patients 90 days after discharge from the hospital. The laboratory parameters at admission, the assessment of quality of life on the modified Rankin scale before admission, in the hospital, at discharge and 90 days after discharge, and the Rivermead mobility index 90 days after discharge were analyzed.

The results of the study. It was revealed that all patients had a moderate stroke upon admission, and 4 subjects (33%) had a recurrent stroke. All patients have comorbidity. 2 patients (16%) have protein deficiency (decreased total protein levels) upon admission. All the studied patients have deep vein thrombosis (DVT), and 2 out of 12 (16%) have symptoms of DVT (swelling of the legs). One patient (8%) had DVT complicated by thromboembolism of the trunk of the LA, its main, lobar, segmental branches on both sides. All the subjects had increased D-dimer levels, which indicates the presence of thrombosis processes in the body.The score on the modified Rankin scale is an average of 2-3 points before admission (mild to moderate impairment), 5 points in the hospital for all patients (severe impairment), 3-4 points upon discharge, and an average of 4 points 90 days after discharge (severe impairment). The Rivermead mobility index is estimated at 4 (+-1) points on average after 90 days after discharge.

Conclusion. We came to the conclusion that the presence of DVT and VTE reduces the rehabilitation potential of stroke patients.

 

 

About the authors

Gulnaz Ramilevna Galieva

Kazan State Medical University

Email: gulnazka993@mail.ru
ORCID iD: 0009-0002-7189-3507

Resident of the Department of Rehabilitation and Sports Medicine

Russian Federation, 49, Butlerova street, 420012, Kazan, Russian Federation

Guzel Khamitovna Starostina

Kazan State Medical University

Author for correspondence.
Email: guzel-star@mail.ru
ORCID iD: 0009-0002-0311-6204

Candidate of Medical Sciences, Associate Professor, Department of Rehabilitation and Sports Medicine, Kazan State Medical University

Russian Federation, 49, Butlerova street, 420012, Kazan, Russian Federation

References

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