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.