In-hospital venous thromboembolism is associated with poor outcome in patients with spontaneous intracerebral hemorrhage: A multicenter, prospective study

Background and objective Patients with intracerebral hemorrhage are susceptible to venous thromboembolism, but the relationship between venous thromboembolism and outcome is largely unknown. We aim to investigate the association of in-hospital venous thromboembolism with functional outcome in patients with intracerebral hemorrhage. Methods From September 2014 through August 2016, we conducted a hospital-based, prospective study by consecutively recruiting eligible patients with first-ever acute spontaneous intracerebral hemorrhage. In-hospital venous thromboembolism was defined as observation of pulmonary embolism or deep vein thrombosis during initial hospitalization. The primary end point was death or disability (modified Rankin Scale 3 to 6) at discharge, 3-month and 1-year follow-up. Logistic analysis was conducted to evaluate the association of venous thromboembolism and poor functional outcome. Results Among 637 participants included in the analysis, the prevalence of venous thromboembolism was 22.6%. After adjusting for confounding factors, venous thromboembolism was independently associated with death or disability at discharge (odds ratio 2.09, 95% confidence interval 1.12–3.85), 3-month follow-up (2.00 [1.12–3.54]) and 1-year follow-up (2.00 [1.14–3.49]). Venous thromboembolism was also an independent indicator of disability (modified Rankin Scale 3–5) among ICH survivors, with odds ratios ranging from 1.93 to 2.08 (all P<0.05). The relationship was stronger in patients with hematoma volume <10 ml (3.24 [1.11–9.46]) and ≥30 ml (2.57 [1.03–6.44]) (P for interaction=0.002) at 1-year follow-up. The results were confirmed by sensitivity analysis. Conclusion In-hospital venous thromboembolism was independently associated with poor outcome at discharge, 3-month and 1-year in patients with intracerebral hemorrhage.