Clinical Patterns of Unprovoked Venous Thromboembolism at a Tertiary Care Center in Bangladesh: A Prospective Observational Study

Abstract

Background: Venous thromboembolism (VTE) is a multifactorial disease, and its risk depends on exposure to risk factors and predisposing conditions. One frequent and difficult clinical issue is the treatment of patients with unprovoked venous thromboembolism (UVTE). The current study was conducted to analyze the pattern of presentation of unprovoked VTE in patients presenting in a tertiary hospital of Bangladesh. Materials and Methods: This prospective cross sectional study was conducted in the Department of Medicine of Dhaka Medical College and Hospital (DMCH) from January 2023 to December 2023 over a period of 12 months. All the patients who presented with UVTE were enrolled in the study. A p value < than 0.05 was considered statistically significant. Results: A total number of 70 patients were enrolled the study after fulfilling the inclusion and exclusion criteria who presented to the Department of Medicine of DMCH, Dhaka, Bangladesh between January 2023 to December 2023. Mean age of the study population was 38 ± 12.5 years. Left lower limb was the most common site for DVT (n=54%). Majority of the patients presented with unilateral disease (n=90%). Out of 70 patients only 3 patients developed PE (4.2%). There was 3 mortalities during the hospital stay of the patients who suffered from PE. Besides, another 2 patients died during the follow up period due to suspected PE though the patients were on standard anticoagulant treatment. Univariate analysis showed female sex, age>40 years, Diabetes mellitus, history of rheumatological disease, history of repeated abortion, elevated D dimer and CRP were risk factors for unprovoked VTE. However multivariate analysis showed only female sex (OR: 2.08, 95%CI:1.091-2.124, p<0.05)) and history of repeated abortion (OR: 3.724, 95%CI:3.716-3.738, p<0.04) were independent predictors of UVTE. Conclusion: The present study analyzed the pattern and risk factors of UVTE in a tertiary center of Bangladesh. Physicians should always search for identifiable cause behind UVTE and aware of the long term outcome of the patients.