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Background <p>Early recognition of venous thromboembolism (VTE) risk and intervention with appropriate thromboprophylaxis are effective for preventing adverse disease outcomes in hospitalized patients. However, there is a paucity of data to know the use of anticoagulant prophylaxis rate in the emergency department of Ethiopia. Therefore, this study aimed to assess the rate of prophylaxis use and associated factors in the emergency department of tertiary care hospitals in Addis Ababa city, Ethiopia.</p> Method <p>A multicentre hospital-based prospective study was conducted in patients admitted to the adult emergency department of three selected tertiary care hospitals. Multivariate logistic regression was performed to identify independent predictors for initiating anticoagulant prophylaxis. <i>P</i> &lt; 0.05 was considered to indicate statistically significant.</p> Results <p>A total of 422 patients were enrolled. Nearly two-thirds (70.64%) of the participants had a Padua Risk Prediction Score of ≥ 4 points, indicating a high risk of developing venous thromboembolism. Among the 296 patients eligible for anticoagulant prophylaxis, only 33.4% received it. Patients who were bedridden ≥ 3 days were three times more likely to receive anticoagulant prophylaxis (adjusted odds ratio (AOR) = 3.129,95% CI = 1.310–7.474, <i>P</i> = 0.001). Similarly, patients aged ≥ 70 years were more likely to receive prophylaxis (AOR) = 1.880, 95% CI = 1.007–3.510, <i>P</i> = 0.047). However, patients with a length of stay (LOS) &lt; 7 days (AOR) = 0.192, 95% CI = 0.095–0.385, <i>P</i> &lt; 0.001) and those who presented with an acute infection (AOR) = 0.619, 95% (CI): 0.342–1.122, <i>P</i> &lt; 0.014) were less likely to receive anticoagulant prophylaxis. </p> Conclusion <p>Thromboprophylaxis was underutilized in the emergency department, even among high-risk patients. Factors such as older age, prolonged immobility, prior VTE, active cancer, infection, and longer emergency department (ED) stay significantly influenced the likelihood of prophylaxis administration.</p> Clinical trial number <p>Not applicable.</p>

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Thromboprophylaxis utilization rate and associated factors among patients attending the emergency department of tertiary care hospitals in Addis Ababa city, Ethiopia: a multicentre prospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月24日

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  • Worku Degefa,
  • Minyahil Alebachew Woldu,
  • Desalew Mekonnen,
  • Alemseged Beyene Berha

摘要

Background

Early recognition of venous thromboembolism (VTE) risk and intervention with appropriate thromboprophylaxis are effective for preventing adverse disease outcomes in hospitalized patients. However, there is a paucity of data to know the use of anticoagulant prophylaxis rate in the emergency department of Ethiopia. Therefore, this study aimed to assess the rate of prophylaxis use and associated factors in the emergency department of tertiary care hospitals in Addis Ababa city, Ethiopia.

Method

A multicentre hospital-based prospective study was conducted in patients admitted to the adult emergency department of three selected tertiary care hospitals. Multivariate logistic regression was performed to identify independent predictors for initiating anticoagulant prophylaxis. P < 0.05 was considered to indicate statistically significant.

Results

A total of 422 patients were enrolled. Nearly two-thirds (70.64%) of the participants had a Padua Risk Prediction Score of ≥ 4 points, indicating a high risk of developing venous thromboembolism. Among the 296 patients eligible for anticoagulant prophylaxis, only 33.4% received it. Patients who were bedridden ≥ 3 days were three times more likely to receive anticoagulant prophylaxis (adjusted odds ratio (AOR) = 3.129,95% CI = 1.310–7.474, P = 0.001). Similarly, patients aged ≥ 70 years were more likely to receive prophylaxis (AOR) = 1.880, 95% CI = 1.007–3.510, P = 0.047). However, patients with a length of stay (LOS) < 7 days (AOR) = 0.192, 95% CI = 0.095–0.385, P < 0.001) and those who presented with an acute infection (AOR) = 0.619, 95% (CI): 0.342–1.122, P < 0.014) were less likely to receive anticoagulant prophylaxis.

Conclusion

Thromboprophylaxis was underutilized in the emergency department, even among high-risk patients. Factors such as older age, prolonged immobility, prior VTE, active cancer, infection, and longer emergency department (ED) stay significantly influenced the likelihood of prophylaxis administration.

Clinical trial number

Not applicable.