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Q J Med 2004; 97: 293-296
QJM vol. 97 no. 5 (c) Association of Physicians 2004; all rights reserved.

Dehydration and venous thromboembolism after acute stroke

J. Kelly1, B.J. Hunt2, R.R. Lewis1, R. Swaminathan3, A. Moody4, P.T. Seed5 and A. Rudd1

From the Departments of 1Elderly Care, 2Haematology and 3Chemical Pathology, Guy's and St. Thomas’ Hospital Trust, London, 5Department of Academic Radiology, Queen's Medical Centre, Nottingham, and 4Directorate of Maternal Health, King's College, London, UK

Received 20 November 2003 and in revised form 10 February 2004

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.

Address correspondence to Dr J. Kelly, Elderly Care Dept, North Wing (9th Floor), St Thomas’ Hospital, Lambeth, London SE1 7EH. e-mail: jameskelly{at}northbrookfm.fsnet.co.uk


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