Introduction: Although venous thromboembolism (VTE) is frequently related to dehydration, the impact of dehydration on VTE in acute ischemic stroke (AIS) is not clear. This study investigated whether dehydration, as measured by blood urea nitrogen (BUN)/creatinine (Cr) ratio, influences the occurrence of VTE in patients with AIS.

Methods: This is a retrospective study of patients with AIS between January 2012 and December 2013. Patients with newly diagnosed AIS who experienced prolonged hospitalization for at least 4 weeks were included in this study.

Results: Of 182 patients included in this study, 17 (9.3%) suffered VTE during the follow-up period; in two cases, VTE was accompanied by deep vein thrombosis and pulmonary embolism. Patients with VTE were more frequently female and had higher National Institutes of Health Stroke Scale (NIHSS) score, more lower limb weakness, and elevated blood urea nitrogen BUN/Cr ratio on admission. In a multivariate analysis, BUN/Cr ratio > 15 (OR 8.75) and severe lower limb weakness (OR 4.38) were independent risk factors for VTE.

Conclusions: Dehydration on admission in cases of AIS might be a significant independent risk factor for VTE.

Patient Care: Our study shows that severe lower limb paresis is associated with VTE. Moreover, an elevated serum BUN/Cr ratio (> 15) is independently associated with an increased risk of VTE. Therefore, physicians should be aware of the danger of dehydration and be attentive to patients with higher BUN/Cr ratios and severe leg paresis. Further investigations of the pathophysiology of VTE are needed, and a larger controlled study is required to assess whether these results hold true in a larger patient population.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of the relationship between dehydration and the risk of venous thromboembolism in acute ischemic stroke, 2) Discuss, in small groups,it is important to identify risk factors capable of predicting the occurrence of DVT, 3) Identify to investigate the relationship between dehydration, as measured by the blood urea nitrogen (BUN)/creatinine (Cr) ratio, and the risk of VTE in patients with acute ischemic stroke.

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