High incidence of undiagnosed deep vein thrombosis among hospitalized people living with HIV: a cross-sectional study.

IF 2.2 4区 医学 Q2 HEMATOLOGY
Robert Bizaleri Baluku, Faith Ameda, Eva Nabawanuka, Christine Sekaggya-Wiltshire
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Abstract

Background: Deep venous thrombosis (DVT) is part of a spectrum of venous thromboembolism, which also includes pulmonary embolism. Up to 50% of hospitalized individuals who develop pulmonary embolism have DVT. Pulmonary embolism is responsible for up to 10% of hospital deaths. However, the burden and specific risk factors for DVT among inpatients living with HIV in our setting are not well established. Thromboprophylaxis, which reduces the risk of DVT, is not routinely administered to all inpatients. Understanding the burden and risk factors for DVT in this population can guide the implementation of preventive measures, identify high-risk individuals, and inform guidelines for thromboprophylaxis.

Methods: This cross-sectional study was conducted between October 2023 and April 2024 in two National Referral hospitals among hospitalized people living with HIV. A total of 186 participants were consecutively sampled and enrolled in the study. All adult inpatients living with HIV who fulfilled the eligibility criteria had a bedside Doppler ultrasound scan of the lower limbs for DVT. Relevant demographic, clinical, laboratory, and HIV-related data were obtained. Both bivariable and multivariable analyses were performed via R software.

Results: Up to 186 participants were enrolled, with a median age of 40 years (interquartile range (IQR): 34-52). The prevalence of lower limb DVT was 18.3% (34/186). The participants with DVT had a median age of 49 years (IQR: 39-56, p-value 0.045). Up to 53% (99/186) of the participants were male. The median duration of hospitalization was 5.0 days (IQR: 4.0-7.8) among those with DVT. A positive history of cigarette smoking was identified in 6.5% (12/34) of the participants and was significantly associated with the development of DVT (P-value = 0.004). TB coinfection was significantly associated with DVT, with a prevalence ratio (PR) of 2.22 (P-value = 0.007). A low CD4 (< 200) was also significantly associated with lower limb DVT (PR = 2.70, P-value = 0.003).

Conclusion: The prevalence of lower limb DVT among hospitalized people living with HIV is high (18.3%) in our setting. Older age, a positive history of smoking, a low CD4 count (< 200), and TB coinfection are significant risk factors for DVT in HIV-positive inpatients.

住院HIV感染者中未确诊深静脉血栓的高发:一项横断面研究
背景:深静脉血栓形成(DVT)是静脉血栓栓塞的一部分,其中也包括肺栓塞。高达50%的肺栓塞住院患者患有深静脉血栓。肺栓塞在医院死亡中占比高达10%。然而,在我们的环境中,感染HIV的住院患者中DVT的负担和具体危险因素尚未得到很好的确定。血栓预防可降低深静脉血栓形成的风险,但并非所有住院患者都常规使用。了解这一人群DVT的负担和危险因素可以指导预防措施的实施,识别高危人群,并为血栓预防指南提供信息。方法:本横断面研究于2023年10月至2024年4月在两家国家转诊医院对住院的HIV感染者进行。共有186名参与者被连续抽样并纳入研究。所有符合资格标准的成年HIV住院患者都进行了下肢多普勒超声扫描以检查深静脉血栓。获得了相关的人口统计学、临床、实验室和艾滋病毒相关数据。双变量和多变量分析均通过R软件进行。结果:共有186名受试者入组,中位年龄为40岁(四分位间距(IQR): 34-52岁)。下肢DVT患病率为18.3%(34/186)。DVT患者的中位年龄为49岁(IQR: 39-56, p值0.045)。高达53%(99/186)的参与者是男性。深静脉血栓患者的中位住院时间为5.0天(IQR: 4.0-7.8)。6.5%(12/34)的参与者有吸烟史,吸烟史与DVT的发生显著相关(p值= 0.004)。TB合并感染与DVT显著相关,患病率(PR)为2.22 (p值= 0.007)。结论:在我们的环境中,住院的HIV感染者下肢DVT患病率很高(18.3%)。年龄较大,有吸烟史,CD4细胞计数低(
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来源期刊
Thrombosis Journal
Thrombosis Journal Medicine-Hematology
CiteScore
3.80
自引率
3.20%
发文量
69
审稿时长
16 weeks
期刊介绍: Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis. Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.
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