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Venous thromboembolism in medical patients during hospitalisation and 3 months after hospitalisation: a prospective observational study

Citation

Khalafallah, AA and Kirkby, BE and Wong, S and Foong, YC and Ranjan, N and Luttrell, J and Mathew, R and Chilvers, CM and Mauldon, E and Sharp, C and Hannan, T, Venous thromboembolism in medical patients during hospitalisation and 3 months after hospitalisation: a prospective observational study, BMJ Open, 6, (8) Article e012346. ISSN 2044-6055 (2016) [Refereed Article]


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Copyright 2016 The Authors Licensed under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/

DOI: doi:10.1136/bmjopen-2016-012346

Abstract

OBJECTIVES: This study was conducted to assess the incidence and risk factors for venous thromboembolism (VTE) in a cohort of medical patients both during the period of hospitalisation and following discharge.

DESIGN: This was a prospective observational study to document the risk profile and incidence of VTE posthospitalisation among all medical patients admitted to our institution during the trial period.

SETTINGS: Primary healthcare. Single tertiary referral centre, Tasmania, Australia.

PARTICIPANTS: A total of 986 patients admitted to the medical ward between January 2012 and September 2012 were included in the study with male to female ratio of 497:489. The mean age of patients was 68 years (range 17-112, SD 16).

RESULTS: Overall, 54/986 patients (5.5%) had a VTE during the study period. Of these, 40/54 (74.1%) occurred during hospitalisation and 14/54 (25.9%) occurred following discharge. VTE risk factors revealed in multivariate analysis to be associated with a previous diagnosis of VTE (p<0.001, OR=6.63, 95% CI 3.3 to 13.36), the occurrence of surgery within the past 30 days (p<0.001, OR=2.52, 95% CI 1.33 to 4.79) and an admission diagnosis of pulmonary disease (p<0.01, OR 3.61, 95% CI 1.49 to 8.76). Mobility within 24 hours of admission was not associated with an increased risk. There was risk of VTE when the length of stay prolonged (p=0.046, OR=1.01, 95% CI 1.00 to 1.03), however it was not sustained with multivariate modelling. VTE-specific prophylaxis was used in 53% of the studied patients. Anticoagulation including antiplatelet agents were administered in 63% of patients who developed VTE.

CONCLUSIONS: This prospective observational study found that 5.5% of the studied patients developed VTE. Among those, 25.9% (14/54) of patients had a detected VTE posthospitalisation with this risk being increased if there was a history of VTE, recent surgery and pulmonary conditions. Thromboprophylaxis may be worth considering in these cohorts. Further study to confirm these findings are warranted.

Item Details

Item Type:Refereed Article
Keywords:Epidemiology, general medicine
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Epidemiology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Blood Disorders
Author:Khalafallah, AA (Professor Alhossain Khalafallah)
Author:Mathew, R (Mr Ronnie Mathew)
Author:Chilvers, CM (Mr Charles Chilvers)
Author:Mauldon, E (Dr Emily Mauldon)
Author:Hannan, T (Dr Terry Hannan)
ID Code:110921
Year Published:2016
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-08-23
Last Modified:2017-11-06
Downloads:72 View Download Statistics

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