- Title
- Proximal deep vein thrombosis among hospitalised medical and obstetric patients in Rwandan university teaching hospitals: prevalence and associated risk factors: a cross-sectional study
- Creator
- Mugeni, Regine; Nkusi, Eugene; Rutaganda, Eric; Musafiri, Sanctus; Masaisa, Florence; Lewis, Kayan Lea; Simpao, Marc; Tugirimana, Pierrot Lundimu; Walker, Timothy David
- Relation
- BMJ Open Vol. 9, Issue 11, no. e032604
- Publisher Link
- http://dx.doi.org/10.1136/bmjopen-2019-032604
- Publisher
- BMJ Group
- Resource Type
- journal article
- Date
- 2019
- Description
- Objectives: To determine the prevalence of proximal deep vein thrombosis (DVT) by ultrasound scanning, as well as associated clinical features and known risk factors, among medical and obstetrics-gynaecology inpatients in two Rwandan tertiary hospitals. Design: Cross-sectional study. Settings: Rwanda teaching hospitals: Kigali and Butare University Teaching Hospitals. Participants: 901 adult patients admitted to the Departments of Internal Medicine and Obstetrics-Gynecology (O&G) who were at least 21 years of age and willing to provide a consent. Outcomes: Prevalence of proximal DVT, clinical features and known risk factors associated with DVT. Methods: Between August 2015 and August 2016, participants were screened for DVT by compressive ultrasound of femoral and popliteal veins, conducted as a monthly cross-sectional survey of all consenting eligible inpatients. Patients completed a self-report survey on DVT risk factors. Prevalence of proximal DVT by compression ultrasonography was the primary endpoint, with univariate and multivariate regression analyses performed to assess associated clinical features and risk factors. Results: Proximal DVT was found in 5.5% of the study population, with similar rates in medical and O&G inpatients. The mean age was 41±16 SD (range, 21-91), 70% were female and 7% were pregnant. Univariate analysis showed active malignancy, immobilisation, prolonged recent travel and history of DVT to be significant risk factors for proximal DVT (all p values <0.05); while only active malignancy was an independent risk factor on multivariate regression (OR 5.2; 95% CI 2.0 to 13). Leg pain or tenderness, increased calf circumference, unilateral limb swelling or pitting oedema were predictive clinical features of DVT on both univariate analysis and multivariate regression (all p values <0.05). Conclusion: Proximal DVT prevalence is high among hospitalised medical and O&G patients in two tertiary hospitals in Rwanda. For reducing morbidity and mortality, research to develop Africa-specific clinical prediction tools for DVT and interventions to increase thromboprophylaxis use in the region are urgently needed.
- Subject
- deep vein thrombosis (DVT); medical and obstetrics; Rwanda; university teaching hospitals; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1455862
- Identifier
- uon:45146
- Identifier
- ISSN:2044-6055
- Rights
- © Author(s) (or their employer(s)) 2019. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
- Language
- eng
- Full Text
- Reviewed
- Hits: 1807
- Visitors: 1880
- Downloads: 85
Collections
Goal 3: Good Health and Well-Being
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT02 | Publisher version (open access) | 324 KB | Adobe Acrobat PDF | View Details Download |