<b>Incidence of Deep Venous Thrombosis Among Hospitalized Bedridden Patients with Neurological Disorders Assessed Through Serial Ultrasound Doppler Examination</b>

Background: Hospitalized patients with neurological disorders are at increased risk of deep venous thrombosis (DVT) due to prolonged immobility, immunosuppressive therapy, and critical illness. Despite the recognized vulnerability of this population, limited local data exist to define the true burden of DVT, and current screening practices may underestimate its incidence due to reliance on single-point ultrasound assessments. Objective: To determine the incidence of DVT among hospitalized bedridden patients with neurological disorders using serial ultrasound Doppler examinations supplemented by D-dimer testing and to identify associated clinical risk factors. Methods: This prospective observational study enrolled 95 patients aged ≥18 years with neurological diagnoses, Modified Rankin Scale (mRS) scores ≥4, and bedridden status for at least seven days, admitted at Services Hospital, Lahore, from December 2024 to June 2025. Patients underwent initial Doppler ultrasound evaluation of proximal lower limb veins, followed by repeat Doppler after five days if initial findings were negative or equivocal. Equivocal cases were adjudicated using a D-dimer threshold of ≥0.50 mg/L. Associations with DVT were analyzed using chi-square tests. Results: The overall DVT incidence was 50.5%. Higher BMI (mean 25.3 vs 23.6 kg/m²; p=0.026), mRS score of 5 (63.9% vs 42.4%; p=0.042), and ischemic stroke diagnosis (66.7% vs 33.3%; p=0.065) were associated with greater DVT risk. Serial Doppler and D-dimer testing increased detection from 22.1% to 50.5%. Conclusion: DVT is common among bedridden neurological patients, with obesity, severe disability, and ischemic stroke contributing significantly to risk. These findings support routine serial screening and intensified thromboprophylaxis in this high-risk population.