Evaluation of venous thromboprophylaxis practices and factors associated with inappropriate use in hospitalized medical patients in Addis Ababa, Ethiopia: a retrospective observational study

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Hospitalization increases the chance of developing venous thromboembolism. Moreover, the risk of thromboembolism of the veins will be increased by co-morbidities, surgery, and current infections, which emphasizes the necessity of meticulous evaluation of high-risk patients and proper pharmacological prophylaxis in order to prevent venous thromboembolism and enhance the outcome of therapy. This study aimed to assess the appropriateness of venous thromboembolism prophylaxis and its associated factors among hospitalized medical patients. A retrospective observational study was conducted from January 2023 to December 2023 on medical patients at Tikur Anbessa Specialized Hospital (TASH). The Padua Prediction Score (PPS) was used to assess the risk and eligibility of thromboprophylaxis among the participants. Descriptive statistics were performed to describe the explanatory and outcome variables. Bivariable and multivariable analysis and Fisher exact tests were performed to assess the factor association with venous thromboembolism prophylaxis. A p-value < 5% was set for statistical significance. A total of 260 patients were included in this study. More than half of the participants,138(53.1%), were male. According to Padua prediction score, 57% (95% CI 46.7%-66.7%) of hospitalized medical patients were at high risk for developing venous thromboembolism. Among the patients treated with thromboprophylaxis, only 62% (95% CI 55.7%-67.8%) of the participants were appropriately treated with venous thromboprophylaxis according to PPS score. Patients with recent surgery or trauma, bed rest or immobility and active cancer were identified as factors associated with inappropriate use of thromboprophylaxis. The study showed that participants with high risk group(PPS ≥ 4) who had cardiovascular diseases were three times likely (AOR, 3.06 95% CI 1.12–8.86, p < 0.05) to be given thromboprophylaxis inappropriately compared to patients with no history of cardiovascular. Moreover, in low risk group participants (PPS < 4), the participants with bed rest or immobility (p value = 0.004), cardiovascular diseases(p value = 0.04) and CNS disorders(p value = 0.045) were significantly associated with inappropriate thromboprophylaxis treatment among hospitalized patients. More than half of hospitalized medical patients were at risk of developing venous thromboembolism. And more than one third of participants were inappropriately treated with venous thromboprophylaxis. Patients with cardiovascular diseases, bed rest or immobility, CNS disorders were more likely to be treated with thromboprophylaxis inappropriately based on the Padua predictive score.