Dehydration and venous thromboembolism after acute stroke

• Published in: QJM : An International Journal of Medicine Vol. 97; no. 5; pp. 293 - 296
• Main Authors: Kelly, J., Hunt, B.J., Lewis, R.R., Swaminathan, R., Moody, A., Seed, P.T., Rudd, A.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.05.2004; Oxford Publishing Limited (England)
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Creatinine - blood; Dehydration - complications; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; General aspects; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Neurology; Osmolar Concentration; Prospective Studies; Risk Factors; Stroke - complications; Urea - blood; Vascular diseases and vascular malformations of the nervous system; Venous Thrombosis - etiology; Nervous system diseases; Hydroelectrolytic balance disorder; Stroke; Acute; Cardiovascular disease; Dehydration; Thrombosis; Embolism; Cerebral disorder; Vascular disease; Medicine; Central nervous system disease; Thromboembolism; Vein; Cerebrovascular disease
• ISSN: 1460-2725; 1460-2393
• DOI: 10.1093/qjmed/hch050

Background: Although it is widely assumed that dehydration predisposes to venous thromboembolism (VTE), there are no clinical studies to support this. Aim: To evaluate the relationship between biochemical indices of dehydration and VTE after acute ischaemic stroke (AIS). Design: 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. Discussion: Dehydration after AIS is strongly independently associated with VTE, reinforcing the importance of maintaining adequate hydration in these patients.