Objective:

To examine the association between absence of early pharmacological thromboprophylaxis and in-hospital DVT after IVT for AIS, and to explore clinical characteristics associated with failure to initiate timely prophylaxis.

Approach:

• Study Design: Single-center retrospective cohort study of 197 patients with AIS treated with IVT from January 2021 to April 2024.
• Definitions: Early pharmacological thromboprophylaxis defined as anticoagulant prophylaxis initiated within 24–48 h after IVT after excluding intracranial hemorrhage.
• Outcome Measurement: Primary outcome was in-hospital lower extremity DVT confirmed by venous ultrasonography.
• Statistical Analysis: Multivariable logistic regression used to identify factors associated with non-initiation of early prophylaxis and to examine the association between absence of early prophylaxis and DVT.

Key Findings:

• Among 197 patients, 118 (59.9%) received early prophylaxis and 79 (40.1%) did not.
• Overall, 32 patients (16.2%) developed in-hospital DVT.
• DVT occurred more frequently in patients without early prophylaxis than in those receiving early prophylaxis (30.4% vs. 6.8%, P < 0.001).
• Absence of early prophylaxis was associated with higher odds of DVT (adjusted OR 3.16, 95% CI 1.19–8.42, P = 0.021).
• Factors associated with non-initiation of early prophylaxis included atrial fibrillation, higher NIHSS score, prolonged bed rest, and elevated D-dimer.

Interpretation:

Limitations:

• Retrospective design limits causal inference.
• Non-randomized treatment allocation may introduce bias.

Conclusion: