Page 94 - ITPS-7-4

INNOSC Theranostics

and Pharmacological Sciences

SHORT COMMUNICATION
An observational study on the use of low-

molecular-weight heparin for venous
thromboembolism prophylaxis in acute stroke

patients

Faizan A. Sandhu* and Revin Thomas
Department of Stroke Medicine, University Hospital North Durham, Durham, United Kingdom

Abstract
Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and
pulmonary embolism (PE) are common complications post-stroke. The UK stroke
guidelines recommend the early use of intermittent pneumatic compression devices
(IPCDs). At our center, we noticed poor compliance with the use of these devices
and sought to develop a pathway for early implementation of low-molecular-weight
heparins (LMWH) instead. We retrospectively analyzed the data of 2351 patients in
two separate groups and compared both groups to check the incidence of PEs and
DVTs as stated on the discharge documentation. Group A consists of 1599 patients
who used IPCDs as VTE prophylaxis, whereas Group B involved 752 patients who were
placed on the new VTE prophylaxis protocol, which involved the early use of LMWH
*Corresponding author:
Faizan Sandhu with enoxaparin delivered subcutaneously. It was observed that IPCDs were not well
(faizan.sandhu@nhs.net) tolerated by patients, leading to poor compliance with VTE prophylaxis in Group A.
Citation: Sandhu FA, Thomas R. VTE compliance was noted to be better in Group B in which the patients were given
An observational study on the use LMWH in the hospital. Furthermore, symptomatic DVT and PE were not found to be
of low-molecular-weight heparin higher in Group B patients, but in fact, the incidence of these conditions was lower
for venous thromboembolism
prophylaxis in acute stroke in this group. In conclusion, compared to IPCDs, LMWH appears to be well tolerated
patients. INNOSC Theranostics by patients during the admission period owing to acute stroke. It was observed that
and Pharmacological Sciences. the incidence of VTE was reduced in patients who started on early LMWH in the
2024;7(4):3250.
doi: 10.36922/itps.3250 post-stroke period. However, the long-term effects of LMWH prophylaxis, in terms of
mortality and morbidity, need to be delineated. Therefore, an additional large trial on
Received: March 25, 2024 the early use of LMWH in comparison to IPCDs is warranted.
Accepted: July 24, 2024
Published Online: October 7, 2024 Keywords: Low-molecular-weight heparin; Venous thromboembolism; Deep vein
Copyright: © 2024 This thrombosis; Pulmonary embolism; Acute stroke; Blood clots; Intermittent pneumatic
is an Open-Access article compression device
distributed under the terms
of the Creative Commons
AttributionNoncommercial License,
permitting all non-commercial use,
distribution, and reproduction in any 1. Introduction
medium, provided the original work
is properly cited. Venous thromboembolism (VTE), a term which encircles both deep vein thrombosis
1
Publisher’s Note: AccScience (DVT) and pulmonary embolism (PE), is a common complication in stroke patients.
Publishing remains neutral with VTE is a considerable cause of morbidity, delayed hospital discharge, and potential
regard to jurisdictional claims in
published maps and institutional increased health-care costs. It has been estimated to account for one-fourth of all deaths
affiliations after stroke. In the early post-stroke phase, the risk of VTE appears to be highest in
2
Volume 7 Issue 4 (2024) 1 doi: 10.36922/itps.3250