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

Asmamaw, Mulugeta; Hungnaw, Wubet; Motbainor, Achenef; Kedir, Hanan Muzeyin; Tadesse, Tamrat Assefa

doi:10.1177/20503121221079488

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…These findings were consistent with a study by Asmamaw et al, which shows that acute infection and/or rheumatologic disorders 76.7% is the most common diagnosis among hospitalized patients. 24 While another study by Ayalew et al showed that acute infection 51.5% and heart or respiratory disease 25.7% are the commonest. 13 Furthermore, this study was conducted through the winter season, and those conditions are prevalent during that period.…”

Section: Discussionmentioning

confidence: 98%

VTE Prophylaxis Therapy: Clinical Practice vs Clinical Guidelines

Abukhalil¹,

Nasser²,

Khader³

et al. 2022

VHRM

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Introduction Venous thromboembolism (VTE) is the most preventable complication in hospitalized patients. The main objective of this study was to evaluate the adherence of current clinical practice to the established guidelines at a Palestinian teaching hospital. Methods This cross-sectional, retrospective, observational study was conducted at a Palestinian Teaching Hospital. The medical records of patients admitted to the medical floor over 18 years of age and hospitalized for longer than 24 hours between January 1 and May 31, 2019, were included. Patients taking anticoagulants with incomplete or duplicated medical records were excluded from the study. A data collection sheet was developed, and clotting and bleeding risks were assessed using the Padua and IMPROVE risk assessment models (scores). The data were analyzed using IBM SPSS (version 25). Results In total, 408 patients were included in the study, 222 of whom received thromboprophylaxis (54.4%). Of the hospitalized patients, 112 (27.5%) had a high risk of developing VTE (Padua score ≥ 4), and 73 patients were eligible for VTE pharmacological prophylaxis; however, only 44 (60.3%) received the appropriate prophylaxis. In addition, 296 patients had low Padua scores, indicating that pharmacological prophylaxis was not indicated. However, 144 (48.6%) patients received prophylaxis. The mean Padua and IMPROVE risk scores were 2.25 ± 2.08 and 4.44 ± 2.72, respectively. Among the patients, 17.6% had a high risk of bleeding (IMPROVE score ≥ 7). Conclusion VTE prophylaxis among hospitalized medically ill patients was mostly inappropriate; 80.18% of the patients received inappropriate prophylaxis, and only 60.3% of eligible patients received appropriate prophylaxis. Adapting assessment models or checklists in clinical practice based on clinical guidelines for VTE risk stratification is a practical and effective method to improve VTE prophylaxis management and select the appropriate therapy to prevent toxicity or complication.

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Section: Discussionmentioning

confidence: 98%

VTE Prophylaxis Therapy: Clinical Practice vs Clinical Guidelines

Abukhalil¹,

Nasser²,

Khader³

et al. 2022

VHRM

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“…A decrease in activity, trauma and/or surgery in less than one month, active tumors, chronic kidney disease, and hypertension are all significantly associated with the occurrence of VTE. 8 In Professor Zhai Zhenguo's study on venous thromboembolism in Chinese inpatients (DissolVE-2), it was found that the main risk factors for surgical and internal medicine inpatients were main surgery (52.6%) and acute infection (42.2%), respectively. 9 Andrea J Darzi conducted a systematic evaluation of the prognostic factors for VTE in hospitalized internal medicine patients and found that the factors with moderate levels of evidence for VTE occurrence were: advanced age, elevated D-dimer levels, and a history of VTE; thrombophilia; cancers; critical illness; and infectious diseases.…”

Section: Discussionmentioning

confidence: 99%

External Validation of the Risk Assessment Model of Venous Thromboembolism in Multicenter Internal Medicine Inpatients

Chen,

Shi,

Chang

et al. 2024

Clin Appl Thromb Hemost

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To external validate the risk assessment model (RAM) of venous thromboembolism (VTE) in multicenter internal medicine inpatients. We prospectively collected 595 internal medical patients (310 with VTE patients, 285 non-VTE patients) were from Beijing Shijitan Hospital, Beijing Chaoyang Hospital, and the respiratory department of Beijing Tsinghua Changgeng Hospital from January 2022 to December 2022 for multicenter external validation. The prediction ability of Caprini RAM, Padua RAM, The International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) RAM, and Shijitan (SJT) RAM were compared. This study included a total of 595 internal medicine inpatients, including 242 (40.67%) in the respiratory department, 17 (2.86%) in the respiratory intensive care unit, 49 (8.24%) in the neurology department, 34 (5.71%) in the intensive care unit, 26 (4.37%) in the geriatric department, 22 (3.70%) in the emergency department, 71 (11.93%) in the nephrology department, 63 (10.59%) in the cardiology department, 24 (4.03%) in the hematology department, 6 (1.01%) in the traditional Chinese medicine department, 9 (1.51%) cases in the rheumatology department, 7 (1.18%) in the endocrinology department, 14 (2.35%) in the oncology department, and 11 (1.85%) in the gastroenterology department. Multivariate logistic regression analysis showed that among internal medicine inpatients, age > 60 years old, heart failure, nephrotic syndrome, tumors, history of VTE, and elevated D-dimer were significantly correlated with the occurrence of VTE ( P < .05). The incidence of VTE increases with the increase of D-dimer. It was found that the effectiveness of SJT RAM (AUC = 0.80 ± 0.03) was better than Caprini RAM (AUC = 0.74 ± 0.03), Padua RAM (AUC = 0.72 ± 0.03) and IMPROVE RAM (AUC = 0.52 ± 0.03) ( P < .05). The sensitivity and Yoden index of SJT RAM were higher than those of Caprini RAM, Pauda RAM, and IMPROVE RAM ( P < .05), but specificity was not significantly different between the 4 models ( P > .05). The SJT RAM derived from general hospitalized Chinese patients has effective and better predictive ability for internal medicine inpatients at risk of VTE.

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“…In summary, this study analyzed the risk factors of thromboembolism in ANCA-associated vasculitis patients, constructed a thrombus risk prediction model and provided a method for the early identification of thrombosis in AAV patients to help clinicians to actively prevent thrombosis in patients with AAV. 27 …”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors and the Establishment of a Predictive Model for Thrombosis in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Zhang¹,

Huang²,

Ren³

et al. 2022

IJGM

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To explore the risk factors for thrombi occurring in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and establish a risk prediction model to better predict the risk of thrombosis in patients with AAV. Patients and Methods: We retrospectively analyzed 117 AAV patients who had been hospitalized in The Second Affiliated Hospital of Chongqing Medical University between October 2010 and December 2021. For all patients, we recorded demographic characteristics and clinical data, analyzed the risk factors for thrombosis in AAV patients and then developed a risk prediction model. Results:Stepwise logistic regression analysis indicated that a high complement C3 level, a high BVAS score and a high Padua score were independent risk factors for thrombosis in AAV patients. According to multivariate analysis, a predictive model for thrombus risk was successfully established; the area under the ROC curve(AUC) was 0.803 (95% CI: 0.716-0.890) and the maximum Youden index, sensitivity and specificity were 0.487, 59.0% and 89.7%, respectively. Conclusion:A high complement C3 level, high BVAS score, and a high Padua score were shown to be independent risk factors for thrombosis in AAV patients. We developed a risk prediction model based on these three risk factors that could predict the risk of thrombosis in AAV patients to some extent.

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

Cited by 5 publications

References 35 publications

VTE Prophylaxis Therapy: Clinical Practice vs Clinical Guidelines

VTE Prophylaxis Therapy: Clinical Practice vs Clinical Guidelines

External Validation of the Risk Assessment Model of Venous Thromboembolism in Multicenter Internal Medicine Inpatients

Analysis of Risk Factors and the Establishment of a Predictive Model for Thrombosis in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

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