Postural abnormality as a risk marker for leg deep venous thrombosis in Parkinson's disease

Pulmonary thromboembolism is a common cause of death in patients with autopsy-confirmed Parkinsonism. This study investigated the incidence of leg deep vein thrombosis in Parkinson's disease and relationships between deep vein thrombosis and clinical/laboratory findings, including postural abno...

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Bibliographic Details
Published in:PloS one 2013-07, Vol.8 (7), p.e66984-e66984
Main Authors: Yamane, Kazushi, Kimura, Fumiharu, Unoda, Kiichi, Hosokawa, Takafumi, Hirose, Takahiko, Tani, Hiroki, Doi, Yoshimitsu, Ishida, Simon, Nakajima, Hideto, Hanafusa, Toshiaki
Format: Article
Language:English
Subjects:
Abnormalities
Aged
Aged, 80 and over
Autopsies
Autopsy
Basal ganglia
Body mass
Body mass index
Body size
Brain diseases
Causes of
Central nervous system diseases
Cross-Sectional Studies
Diabetes
Diabetes mellitus
Dopa
Dopamine
Doppler effect
Dosage and administration
Drug dosages
Drugs
Edema
Elevation
Embolisms
Female
Health risk assessment
Health risks
Humans
Incidence
Influence
Internal medicine
Knee
Laboratories
Leg
Leg - diagnostic imaging
Leg - pathology
Levodopa
Logistic Models
Lung diseases
Male
Markers
Measurement methods
Medicine
Middle Aged
Movement disorders
Muscle pain
Neurology
Parkinson Disease - complications
Parkinson Disease - diagnostic imaging
Parkinson Disease - pathology
Parkinson's disease
Patients
Posture
Posture disorders
Regression analysis
Risk
Risk Factors
Risk groups
Spine
Stroke
Thromboembolism
Thrombosis
Thyroid diseases
Ultrasonography
Ultrasound
Ultrasound imaging
Veins & arteries
Venous thrombosis
Venous Thrombosis - complications
Venous Thrombosis - diagnostic imaging
Venous Thrombosis - pathology
Wheelchairs
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Summary:Pulmonary thromboembolism is a common cause of death in patients with autopsy-confirmed Parkinsonism. This study investigated the incidence of leg deep vein thrombosis in Parkinson's disease and relationships between deep vein thrombosis and clinical/laboratory findings, including postural abnormalities as assessed by photographic measurements. This cross-sectional study assessed the presence of deep vein thrombosis using bilateral leg Doppler ultrasonography in 114 asymptomatic outpatients with Parkinson's disease. Deep vein thrombosis was detected in 23 patients (20%) with Parkinson's disease. Deep vein thrombosis was located in the distal portion in 18 patients and in the proximal portion in 5 patients. No significant differences in age, sex, body mass index, disease duration, Hoehn-Yahr stage, anti-Parkinson's drugs, or daily levodopa-equivalent dose were seen between deep vein thrombosis-positive and -negative groups. Univariate analysis for developing deep vein thrombosis in patients with Parkinson's disease identified the following markers: long-term wheelchair use, bent knee, bent spine, and D-dimer elevation. Bending angles were significantly greater in the deep vein thrombosis-positive group at the knee and spine than in the deep vein thrombosis-negative group. Half of Parkinson's disease patients with camptocormia had deep vein thrombosis. Among diabetes mellitus cases, long-term wheelchair use, bent knee over 15°, camptocormia, D-dimer elevation, the more risk markers were associated with a higher incidence of DVT. The presence of risk markers contributed to the development of deep vein thrombosis. On multivariate logistic regression analysis, a bent knee posture was strongly associated with an increased risk of deep vein thrombosis. Presence of leg deep vein thrombosis correlated with postural abnormalities in Parkinson's disease. We recommend non-invasive ultrasonographic screening for leg deep vein thrombosis in these high-risk patients with Parkinson's disease.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0066984