Predictive Value of Combining Padua Score with D-Dimer for Deep Vein Thrombosis in Acute Ischemic Stroke Patients with Alteplase.

Abstract

Background: This study aimed to evaluate the predictive value of combining the Padua score with D-dimer levels for identifying lower extremity deep vein thrombosis (DVT) in acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis with alteplase.

Methods: This retrospective study analyzed clinical data from 632 AIS patients who received alteplase treatment at our hospital between September 2019 and October 2023. After applying strict inclusion and exclusion criteria, a total of 172 patients were included in the analysis: 35 patients in the DVT group and 137 patients in the non-DVT group. The area under the receiver operating characteristic curve (AUC) was used to compare the predictive per-formance of the Padua score, D-dimer levels, and their combination.

Results: Both the Padua score and D-dimer levels were significantly higher in the DVT group compared to the non-DVT group (p < 0.05). The individual AUC values for the Padua score and D-dimer were 0.805 and 0.691, respectively, with no statistically significant difference between them (p > 0.05). However, when combined, the AUC value increased to 0.828, with a Youden index of 0.591, sensitivity of 0.686, and specificity of 0.905. These metrics were all significantly higher than those obtained using the Padua score or D-dimer alone, demonstrating a statistically significant improvement in predictive accuracy (p < 0.05).

Conclusions: The combination of the Padua score and D-dimer levels can serve as an effective early warning tool for DVT in AIS patients treated with intravenous alteplase thrombolysis, thereby enhancing the early detection and management of DVT in this patient population.