Asmamaw Mulugeta, Hungnaw Wubet, Motbainor Achenef, Kedir Hanan Muzeyin, Tadesse Tamrat Assefa
Department of Internal Medicine, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
SAGE Open Med. 2022 Feb 21;10:20503121221079488. doi: 10.1177/20503121221079488. eCollection 2022.
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.
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.
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.
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.
静脉血栓栓塞是住院患者死亡和发病的主要原因之一，而血栓预防是减少此类事件的关键策略之一。我们旨在使用帕多瓦预测评分评估埃塞俄比亚巴赫达尔市提贝贝·吉翁专科医院住院内科患者的静脉血栓栓塞风险、血栓预防措施及结果。
于2018年12月1日至2019年5月31日对提贝贝·吉翁专科医院收治的219例患者进行了一项横断面研究。使用预先测试的数据提取格式从患者病历中收集数据，以收集患者的临床信息，并使用帕多瓦预测评分评估静脉血栓栓塞风险。我们使用社会科学统计软件包第26版进行数据分析。描述性统计用于总结研究结果，二元逻辑回归分析用于评估相关变量之间的关联。
活动减少、近期创伤和/或手术、心脏和/或呼吸衰竭以及活动性癌症是常见的静脉血栓栓塞危险因素。根据帕多瓦预测评分，48.4%的患者发生静脉血栓栓塞的风险较高。仅对55例（25.1%）患者进行了静脉血栓栓塞预防，其中15例发生静脉血栓栓塞的风险较低（帕多瓦评分<4分），不符合血栓预防条件。15例（6.84%）患者在住院期间发生了静脉血栓栓塞事件，其中80%来自高风险组。女性发生静脉血栓栓塞的几率比男性高14倍以上（调整后的优势比=14.51；95%置信区间：2.52-83.39，p=0.003）。活动减少（调整后的优势比=10.00；95%置信区间：1.70-58.70）、<1个月的创伤和/或手术（调整后的优势比=18.93；95%置信区间：2.30-155.56）、活动性癌症（调整后的优势比=6.00；95%置信区间：1.05-34.27）、慢性肾脏疾病（调整后的优势比=61.790；95%置信区间：2.627-1453.602）和高血压（调整后的优势比=7.270；95%置信区间：1.105-47.835）与发生静脉血栓栓塞的风险显著相关。
近一半的患者有发生静脉血栓栓塞的风险。提贝贝·吉翁专科医院普遍存在血栓预防措施使用不足和预防措施使用不当的情况。
