Two Steps Can Reduce the Incidence of Secondary Stroke

By Mark Reiter, MD, MBA, FAAEM (CEO, Emergency Excellence; Residency Director, Emergency Medicine Residency, University of Tennessee-Murfreesboro/Nashville; President, American Academy of Emergency Medicine) and Brian Fengler, MD, FAAEM (CEO, EvidenceCare; Assistant Professor, Emergency Medicine Residency, University of Tennessee-Murfreesboro/Nashville).

In their recent article in Practical Neurology, Dr Mark Reiter and Dr Brian Fengler write about the need for better use of venous thromboembolism (VTE) prophylaxis to prevent secondary stroke in admitted patients:

Stroke is a leading cause of death and disability in the U.S. with over 800,000 cases per year (with one in every four being recurrent). Many of these patients suffer not only from the deficits of their stroke, but also from secondary complications within days of their initial presentation.

Venous thromboembolism (VTE) is one such complication and can manifest as a deep-vein thrombosis (DVT) or a more deadly pulmonary embolism (PE). VTE occurs in up to 117 patients per 100,000 population annually with the Centers for Disease Control and Prevention (CDC) estimating that over 500,000 hospitalizations occur each year.

Studies show that 20 to 42 percent of hospitalized stroke patients will suffer from VTE[1] with rates increased in patients with leg weakness (which often occurs in stroke victims) and highest in those who do not receive prophylactic therapy

Despite these statistics, the use of VTE prophylactic treatment has been shown to be suboptimal for admitted patients in general. When specifically looking at stroke patients, it has been found to be “underutilized and rarely started after the first day of hospitalization”.

Dr Mark Reiter and Dr Brian Fengler recommend two key steps:

  1. Use Intermittent Pneumatic Compression
  1. Ensure Stroke Patients are Assessed and Treated
Two Steps Can Reduce the Incidence of Secondary #Stroke #ptsafety Click To Tweet

The effect on patient lives will be tremendous they say:

By remembering just two things – using IPC and ensuring all stroke patients are assessed and treated – the lives and well-being of thousands of stroke patients may be saved and improved.

use #IPC and ensure all #stroke patients are assessed and treated #ptsafety Click To Tweet

To read further about the two recommended key steps and the role that the Stroke VTE Safety Recommendations can play in assisting with improved compliance, please read their article in Practical Neurology.

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