Incidence of thromboembolism and thromboprophylaxis in medical patients admitted to specialized hospital in Ethiopia using Padua prediction score

Abstract

Introduction: Venous thromboembolism is a major cause of mortality and morbidity among hospitalized patients and thromboprophylaxis is one of the key strategies to reduce such events. We aimed to assess venous thromboembolism risk using Padua prediction score, thromboprophylaxis practice, and outcomes in hospitalized medical patients at Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia. Methods: A cross-sectional study was conducted among 219 patients admitted to Tibebe Ghion Specialized Hospital from 1 December 2018 to 31 May 2019. Data were collected from patients’ medical records using a pre-tested data abstraction format to collect patients’ clinical information and venous thromboembolism risk using the Padua prediction score. We used Statistical Package for the Social Sciences version 26 for data analysis. Descriptive statistics was used to summarize the findings, and binary logistic regression analysis was used to assess association between the variables of interest. Results: Reduced mobility, recent trauma and/or surgery, heart and/or respiratory failure, and active cancer were the frequently identified venous thromboembolism risk factors. Based on Padua prediction score, 48.4% of patients were at high risk of developing venous thromboembolism. The venous thromboembolism prophylaxis was given only for 55 (25.1%) patients and 15 of them were at low risk of developing venous thromboembolism (<4 Padua score) and were ineligible for thromboprophylaxis. Fifteen (6.84%) patients developed venous thromboembolism events during their stay at the hospital and 80% of them were from high risk group. The odds of females to develop venous thromboembolism were more than 14 times higher (adjusted odds ratio = 14.51; 95% confidence interval: 2.52–83.39, p = 0.003) than males. Reduced mobility (adjusted odds ratio = 10.00; 95% confidence interval: 1.70–58.70), <1 month trauma and/or surgery (adjusted odds ratio = 18.93; 95% confidence interval: 2.30–155.56), active cancer (adjusted odds ratio = 6.00; 95% confidence interval: 1.05–34.27), chronic kidney diseases (adjusted odds ratio = 61.790; 95% confidence interval: 2.627–1453.602), and hypertension (adjusted odds ratio = 7.270; 95% confidence interval: 1.105–47.835) were significantly associated with the risk of developing venous thromboembolism. Conclusion: Nearly half of the patients were at risk of developing venous thromboembolism. Underutilization of thromboprophylaxis and inappropriate use of prophylaxis were commonly seen in Tibebe Ghion Specialized Hospital.