Treatment Outcome of Deep Venous Thrombosis and Associated Factors among patients in Selected Hospitals of Addis Ababa; Ethiopia, Multi center Retrospective cross-sectional Study
No Thumbnail Available
Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Pulmonary embolism and deep venous thrombosis are the two most important
manifestations of venous thromboembolism (VTE).Anticoagulation is the mainstay of treatment.
The aim of treatment of deep vein thrombosis (DVT) is to reduce morbidity and mortality. The
major outcomes of DVT are death, recurrence and major bleeding due to anticoagulation
therapy.
Objective: To evaluate treatment outcome and associated factors among patients diagnosed with
DVT in Tikur Anbessa Specialized Hospital, St. Paul’s Hospital Millennium Medical College
and Zewditu Memorial Hospital.
Methods: A retrospective cross-sectional study was conducted from October to March, 2021
among DVT patients admitted to wards of Tikur Anbessa Specialized Hospital, Zewditu
Memorial Hospital and St. Paul’s Hospital Millennium Medical College from July 1, 2017, to
July 2020 (3 years). Patient specific data was collected by using structured data collection tool.
Data were collected and entered into Epi info 4.6.0.6 and analyzed using SPSS version 25.
Binary logistic regression analysis was used to determine independent predictors of DVT
treatment outcome. Candidate variables associated with the outcomes of interest (P<.25 in the
bivariate analysis) were included in multivariate logistic regression analysis model.
Results: The mean age of the study participants was 45.2, years (±15.36). Risk factors of DVT
include immobilization (29.9%), previous surgery (27.5%), cancer (21.1), unprovoked (23),
previous VTE (20.6%), infection (19.6%) and advanced age (>75 years) (8.1%). DVT recurrence
rate was 22.5%. In a multivariate logistic regression analysis participants with bilateral DVT
(AOR=2.8, 95%CI=1.14, 6.66), obese participants (AOR=3.3, 95%CI=1.15, 9.59), participants
with hypertension (AOR=6.5, 95%CI=2.90, 14.70), participants with retro viral infection (RVI)
(AOR=6.3, 95%CI=2.34, 16.94), baseline international normalized ratio (INR) (2-3) (AOR=6.6,
95%CI=2.86, 15.37) increase in likelihood of developing recurrence DVT. During the study
period 2.2% of the participants died and 19.9% developed complication. Participants who had
major bleeding were 4.5% with bilateral DVT (AOR=3.9, 95%CI=1.6, 9.7), participants having
active cancer (AOR=6.5, 95% =2.9, 14.75) and whose age >75 years (AOR=6.8, 95%CI=2.03,
22.33) had increase risk of major bleeding than the opposite compartment.
ii
Conclusions: In the current study, the overall DVT recurrence rate was 22.5%, which is
complicated by pulmonary embolism and causes 2.2% death. Patients who presented with PE
had higher rates of death compared with patients with isolated DVT. Efforts are needed to
identify patients who are most at risk for VTE complications and to develop better
anticoagulation strategies suitable for long-term use and improve the treatment outcomes.
Description
Keywords
Deep Vein Thrombosis, Recurrence, Risk Factors, bleeding and Addis Ababa