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. 2020 Jan-Dec:26:1076029620941077.
doi: 10.1177/1076029620941077.

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

Abera Mulatu  1 , Tsegaye Melaku  2 , Legese Chelkeba  2
Affiliations

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

Abera Mulatu et al. Clin Appl Thromb Hemost. 2020 Jan-Dec.

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.

Keywords: bleeding; deep vein thrombosis; pulmonary embolism; recurrence.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Study participant recruitment flow diagram.
Figure 2.
Figure 2.
In-hospital medications used by study participants from March to August, 2018. CV indicates cardiovascular; GI, gastrointestinal; JUMC, Jimma University Medical Center, SPHMMMC, St Paul Hospital Millennium Medical College; LMWH, low molecular weight heparin; UFH, unfractionated heparin.
Figure 3.
Figure 3.
Survival function estimates of cumulative incidence of DVT recurrence event derived from Log rank Kaplan Meier; early warfarin therapy (A), length of hospital stay (B), HAS BLED score (C), and gender of patients (D).
See this image and copyright information in PMC

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