Anatomical sites and clinical characteristics of venous thromboembolism in a tertiary hospital

• Main Authors: Saeed Alshahrani, Abdulrahman Alfawzan, Ahmad Alswaidan, Ala Alkharaan, Mohammed Alabduljabar, Altaf Khan, Mohsen Alzahrani
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Journal of Applied Hematology
• Subjects: deep-vein thrombosis; provoked venous thromboembolism; pulmonary embolism; unprovoked venous thromboembolism; venous thromboembolism
• Online Access: http://www.jahjournal.org/article.asp?issn=1658-5127;year=2020;volume=11;issue=3;spage=126;epage=131;aulast=Alshahrani

BACKGROUND: Thrombosis is simply the inappropriate activation of clotting factors that occurs in veins. Venous thromboembolism (VTE) is a common medical problem in hospitalized patients that might progress into serious lethal complications. Provoked VTE is associated with well-known risk factors, while unprovoked VTE remains idiopathic. OBJECTIVES: The aim of this study is to describe the anatomical sites, clinical characteristics, and factors associated with recurrence of the thrombotic event within 5 years. METHODS: This retrospective cross-sectional study was conducted in King Abdulaziz Medical City (KAMC), which included 351 hospitalized patients consecutively. We included all Saudi adults diagnosed with initial VTE in 2006–2017 at KAMC. Patients with incomplete medical charts were excluded. The data collected from electronic charts were analyzed using SAS-9.4. RESULTS: Among the 351 participants, 52% were female and two-thirds (62.4%) exceeded the normal body mass index. Provoked VTE (53.5%) was slightly more prevalent than unprovoked VTE (46.4%), but unprovoked VTE was more frequent in populations with recurrent VTE at 19.1%. The most common VTE sites were the left lower limb (38.5%) followed by right lower limb (20.5%) then bilateral lower limbs (12.2%). Only pulmonary embolisms (<0.01) and unprovoked VTE (0.01) were associated with a higher risk of recurrence. However, unprovoked VTE (P = 0.0305) was the only one associated with a higher risk of recurrence after multivariant analysis. CONCLUSION: Venous thrombosis presents mostly with multiple clinical comorbidities in hospitalized patients. Unprovoked VTE was the only risk factor associated with recurrence after multivariant analysis.