Association between Complete Blood Count Parameters and Venous Thromboembolism Risk Scores in Hospitalized Patients at a Tertiary Hospital in Nigeria

Abstract

Background: A dose-dependent increase in the risk of venous thromboembolism (VTE) has been reported with higher monocyte counts and red cell distribution width (RDW) in patients with thrombosis. Although the D-dimer assay remains the most widely used biomarker for VTE assessment, it is limited by a high rate of negative imaging results. Moreover, in resource-limited settings such as ours, there is a need for cost-effective screening strategies for VTE risk assessment. Objective: To evaluate the association between Complete Blood Count (CBC) parameters, D-dimer, and Lupus Anticoagulant (LA) with VTE risk scores among hospitalized patients at risk of VTE in Enugu State, Nigeria. Methods: The study population comprised medical patients, surgical patients, and healthy control subjects. The study was a cross sectional study, VTE risk was assessed using the Caprini Risk Assessment Model (RAM) and high VTE risk was defined using the Caprini Risk Assessment Model (RAM ≥5). Results: Among surgical patients, univariate analysis showed no significant association between most assayed parameters and high VTE risk (P > 0.05), except for mean corpuscular haemoglobin concentration (MCHC) (OR: 0.54; 95% CI: 0.30–0.98; P = 0.044). After adjustment for sex, age, body mass index (BMI), and ABO blood group in the multivariate model, the inverse association between MCHC and high VTE risk persisted (OR: 0.39; 95% CI: 0.18–0.86; P = 0.020), alongside a significant association with lymphocyte count (OR: 0.36; 95% CI: 0.30–0.98; P = 0.037). In medical patients, univariate analysis revealed no significant associations between any blood count parameters and high VTE risk (P > 0.05). Conclusion: This study demonstrates a significant association between MCHC and VTE risk scores among surgical patients. However, larger studies with longitudinal follow-up are required to establish the predictive value of these parameters for the actual development of VTE events.