title: Risk assessment of deep-vein thrombosis after acute stroke: a prospective study using clinical factors.
abstract: OBJECTIVE
  Deep-vein thrombosis (DVT) represents a serious complication in acute stroke patients with pulmonary embolus (PE) as a potential outcome. Prediction of DVT may help with formulating a proper prevention strategy. To assess of the risk of deep venous thrombosis (DVT) in acute stroke patients, we developed and validated a clinical score in a cohort study.
  
  
  METHODS
  Incidence of Deep Venous Thrombosis after Acute Stroke in China (INVENT-China) is a multicenter prospective cohort study. The potential predictive variables for DVT at baseline were collected, and the presence of DVT was evaluated using ultrasonography on the 14 ± 3 days. Data were randomly assigned to either a training data set or a test data set. Multivariate logistic regression analysis was used to develop risk scores to predict DVT in the training data set and the area under the receiver operating characteristic curve to validate the score in the test data set.
  
  
  RESULTS
  From 2006-2007, 862 hospital-based acute stroke patients were enrolled in China. The overall incidence of DVT after acute stroke within two weeks was 12.4% (95%CI 10.3-14.7%). A seven-point score derived in the training data set (age [≥65 years = 1], sex [female gender = 1]), obesity [BMI ≥ 25 kg/m(2) = 1], active cancer [yes = 2], stroke subtype [cerebral hemorraghe = 1], muscle weakness [≥2 on Lower limb NIHSS score = 1] was highly predictive of 14-day risk of DVT(c statistic = 0.70, 95% CI, 0.64-0.76, P < 0.001), in the overall study population(c statistic = 0.65, 95% CI 0.59-0.70, P < 0.001).
  
  
  CONCLUSIONS
  This clinical score may help identify acute stroke patients with high risk of DVT. In addition, it also serves as a platform to develop further models of DVT prediction in stroke patients based on clinical factors.
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital affiliated Capital Medical University, Beijing, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Liu
authors.forename: Hua-Guang
authors.initials: HG
authors.lastname: Zheng
authors.forename: David Z
authors.initials: DZ
authors.lastname: Wang
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Mohammed
authors.initials: M
authors.lastname: Hussain
authors.forename: Hai-Xin
authors.initials: HX
authors.lastname: Sun
authors.forename: An-Xin
authors.initials: AX
authors.lastname: Wang
authors.forename: Xing-Quan
authors.initials: XQ
authors.lastname: Zhao
authors.forename: Ke-Hui
authors.initials: KH
authors.lastname: Dong
authors.forename: Chun-Xue
authors.initials: CX
authors.lastname: Wang
authors.forename: Wen
authors.initials: W
authors.lastname: He
authors.forename: Bin
authors.initials: B
authors.lastname: Ning
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D002681:China; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012372:ROC Curve; D012306:Risk; D018570:Risk Assessment; D020521:Stroke / Q000150:complications*; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*
keywords: Acute stroke; clinical prediction scale; deep venous thrombosis; prophylaxis