Deep Venous Thrombosis Recurrence and Its Predictors at Selected Tertiary Hospitals in Ethiopia: A Prospective Cohort Study

Abstract

Deep venous thrombosis (DVT) is a common clinical problem associated with substantial morbidity and mortality. Knowledge of the global burden of DVT recurrence is deficient in Africa, including Ethiopia. The objective of the study was to assess deep venous thrombosis recurrence and its predictors at selected tertiary hospitals in Ethiopia. Prospective cohort study was conducted among hospitalized DVT patients. Data were analyzed using SPSS version 21.0. To identify the independent predictors of DVT-recurrence, multiple stepwise-backward Cox-regression analysis was done. Statistical significance was considered at P value < .05. A total of 129 participants were included (65.1% females) with mean ± SD age of 38.63 ± 17.67 years. About 26.4% of patients developed recurrent venous thromboembolism. Pulmonary embolism accounted for 17.60% of recurrent event. The overall incidence density of DVT recurrence was 2.99 per 1000 person-days. The mean ± SD survival time to DVT recurrence was 42.03 ± 22.371 days. Age ≥ 50 years (adjusted hazard ratio [AHR]: 5.566; 95% CI: 1.587-19.518; P = .007), occasional alcohol consumption (AHR: 2.011; 95% CI: 1.307-6.314; P = .019), surgical history (AHR: 6.218; 95% CI: 1.540-25.104; P = .010), pregnancy (AHR: 2.0911; 95% CI: 1.046-4.179; P = .037), diabetes mellitus (AHR: 8.048; 95% CI: 2.494-25.966; P < .001), unmet activated partial thromboplastin time target after 24 hours of heparin (AHR: 1.129; 95% CI: 0.120-10.600; P = .011), proximal site involvement (AHR: 5.937; 95% CI: 1.300-27.110; P = .022), and previous history of DVT (AHR: 2.48; 95% CI: 1.085-11.20; P = .0002) were independent predictors of DVT recurrence. The DVT recurrence rate was high in the study area, which is even complicated with pulmonary embolism as well as death. Efforts are needed to prevent and reduce the development of DVT recurrence.