Utilization of venous thromboembolism prophylaxis among medical and surgical inpatients at jimma university medical center

Abstract

Background: Venous thromboembolism (VTE)-comprising deep vein thrombosis (DVT) and pulmonary embolism (PE)-is a leading cause of cardiovascular morbidity and mortality. It significantly affects patient outcomes by increasing discomfort, hospital stay duration, and healthcare costs. Both medical and surgical inpatients are at elevated risk of VTE. Clinical trials have demonstrated that appropriate VTE prophylaxis reduces symptomatic DVT, PE, and associated mortality. Objectives: Aim of the study was to determine burdens of VTE high risk and utilization of thromboprophylaxis among medical and surgical inpatients at Jimma University Medical Center (JUMC). Methods: An institution based cross-sectional study was conducted among 371 (medical 126, surgical 245) inpatients from December 1, 2024 to February 30, 2025 G.C. Participants were selected using a consecutive sampling method from medical, surgical, orthopedics and gynecology ward . Data was collected from medical record and by interviewing participant using structured questionnaires drafted from different literatures review. The collected data was entered to Epidata version 3.1, then exported to SPSS version 25 for Analysis. Descriptive statistics was used to describe categorical variables as frequency and percentages while continuous data was described using mean, median and standard deviation. Multivariate logistic regression identified factors associated with appropriate thromboprophylaxis and statistical significance declared at p value of <0.05. Results: Among 371 participants (53.4% male), the mean age was 38 years (±15.86). Of surgical inpatients, 82% were at high or highest risk of VTE, but only 15.1% received prophylaxis. Among medical inpatients, 68% were at high risk according to the Padua Prediction Score, yet only 19.8% received appropriate prophylaxis. Factors significantly associated with appropriate prophylaxis were age ≥75 years (AOR: 3.92; 95% CI: 2.11–8.03) ; high VTE risk score (AOR: 5.01; 95% CI: 1.003–18.07).and respiratory diseases (OR = 4.283; 95% CI: 3.900–20.367 P value =0.002). Conclusion and recommendation: This study highlights a significant gap in the implementation of VTE prophylaxis, especially among high-risk surgical and medical inpatients. Adopting VTE risk assessment and thromboprophylaxis protocol and staff training is crucial to prevent this potentially fatal yet preventable condition.