Dehydration and venous thromboembolism after acute stroke.
BACKGROUND
Although it is widely assumed that dehydration predisposes to venous thromboembolism (VTE), there are no clinical studies to support this.


OBJECTIVE
To evaluate the relationship between biochemical indices of dehydration and VTE after acute ischaemic stroke (AIS).


METHODS
Prospective observational study.


METHODS
Unselected AIS patients (n = 102) receiving standard thromboprophylaxis with aspirin and graded compression stockings, underwent serial measurements of serum urea, creatinine and osmolality, and were screened for VTE using magnetic resonance direct thrombus imaging.


RESULTS
Serum osmolality of >297 mOsm/kg, urea >7.5 mmol/l and urea:creatinine ratio (mmol:mmol) >80 a few days post-AIS were associated with odds ratios for VTE of, respectively, 4.7, 2.8 and 3.4 (p = 0.02, 0.05, 0.02) on multivariable analysis.


CONCLUSIONS
Dehydration after AIS is strongly independently associated with VTE, reinforcing the importance of maintaining adequate hydration in these patients.
Kelly
J
J
Department of Elderly Care, Haematology and Chemical Pathology, Guy's and St. Thomas' Hospital Trust, London, UK. jameskelly@northbrookfm.fsnet.co.uk
Hunt
B J
BJ
Lewis
R R
RR
Swaminathan
R
R
Moody
A
A
Seed
P T
PT
Rudd
A
A
D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood; D003681:Dehydration / Q000150:complications*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications*; D014508:Urea / Q000097:blood; D020246:Venous Thrombosis / Q000209:etiology*
D014508:Urea; D003404:Creatinine