Implementation of early prophylaxis for deep-vein thrombosis in intracerebral hemorrhage patients: an observational study from the Chinese Stroke Center Alliance.
Ran Zhang, Weige Sun, Yana Xing, Yongjun Wang, Zixiao Li, Liping Liu, Hongqiu Gu, Kaixuan Yang, Xin Yang, Chunjuan Wang, Qingbo Liu, Qian Xiao, Weixin Cai
Author Information
Ran Zhang: Nursing Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China.
Weige Sun: Nursing Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China.
Yana Xing: Nursing Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China.
Yongjun Wang: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Zixiao Li: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Liping Liu: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Hongqiu Gu: China National Clinical Research Center for Neurological Diseases, Beijing, China.
Kaixuan Yang: China National Clinical Research Center for Neurological Diseases, Beijing, China.
Xin Yang: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Chunjuan Wang: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Qingbo Liu: Nursing Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China.
Qian Xiao: School of Nursing, Capital Medical University, 100069, Beijing, China. julia.xiao@163.com.
Weixin Cai: Nursing Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, 100070, Beijing, China. ttyyhlb@163.com.
BACKGROUND: There is substantial evidence to support the use of several methods for preventing deep-vein thrombosis (DVT) following intracerebral hemorrhage (ICH). However, the extent to which these measures are implemented in clinical practice and the factors influencing patients' receipt of preventive measures remain unclear. Therefore, we aimed to evaluate the rate of the early implementation of DVT prophylaxis and the factors associated with its success in patients with ICH. METHODS: This study enrolled 49,950 patients with spontaneous ICH from the Chinese Stroke Center Alliance (CSCA) between August 2015 and July 2019. Early DVT prophylaxis implementation was defined as an intervention occurring within 48 h after admission. Univariate and multivariate logistic regression analyses were conducted to identify the rate and factors associated with the implementation of early prophylaxis for DVT in patients with ICH. RESULTS: Among the 49,950 ICHpatients, the rate of early DVT prophylaxis implementation was 49.9%, the rate of early mobilization implementation was 29.49%, and that of pharmacological prophylaxis was 2.02%. Factors associated with an increased likelihood of early DVT prophylaxis being administered in the multivariable model included receiving early rehabilitation therapy (odds ratio [OR], 2.531); admission to Stroke unit (OR 2.231); admission to intensive care unit (OR 1.975); being located in central (OR 1.879) or eastern regions (OR 1.529); having a history of chronic obstructive pulmonary disease (OR 1.292), ischemic Stroke (OR 1.245), coronary heart disease or myocardial infarction (OR 1.2); taking antihypertensive drugs (OR 1.136); and having a higher Glasgow Coma Scale (GCS) score (OR 1.045). Conversely, being male (OR 0.936), being hospitalized in tertiary hospitals (OR 0.778), and having a previous intracranial hemorrhage (OR 0.733) were associated with a lower likelihood of early DVT prophylaxis being administered in patients with ICH. CONCLUSIONS: The implementation rate of early DVT prophylaxis among Chinese patients with ICH was subpar, with pharmacological prophylaxis showing the lowest prevalence. Various controllable factors exerted an impact on the implementation of early DVT prophylaxis in this population.
