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.

Association of Remote History of Venous Thrombosis With Risk of Venous Thrombosis After Age 70 Years

“…Several cohort studies showed that a previous history of VT was associated with recurrence of VT in the population younger than 70 years and a previous history of VT was independently associated with VT recurrence. 9 , 10 , 11 , 12 , 13 , 14 However, these studies generally had a short follow-up of less than 10 years, so evaluation of the association of prior VT with health and VT risk in older people could not be determined. The findings of the present study are important because they provide clinicians with quantitative information that might allow them to be aware of a future VT in people presenting for primary care or with impending provoking VT risk settings such as surgery.…”

Do Patients with a Family or Personal History of Venous Thromboembolism have an Increased Risk of Recurrence?

“…However, patients aged ≥ 65 years not only represent the majority of patients with VTE, 40 older patients are underrepresented in most previous studies examining the association between FH/PH status and recurrence. 8 9 10 11 12 13 45 50 51 Second, we used a mix of patient interviews and hospital chart review to establish FH/PH status. Patient interviews may be subject to recall bias and potentially under- or overestimate the true prevalence of FH/PH.…”

Nurses’ Knowledge, Perceived Practice, and their Associated Factors regarding Deep Venous Thrombosis (DVT) Prevention in Amhara Region Comprehensive Specialized Hospitals, Northwest Ethiopia, 2021: A Cross-Sectional Study

“…Deep venous thrombosis is considered the third most common cardiovascular condition following myocardial infarction and stroke, and it is a growing public health problem with 26.4% of recurrent after the patients have been diagnosed, and this results in further cost of treatment for patients and intensifies hospital's burden [ 8 ].…”