Abstract
BACKGROUND: Despite recognized evidence that venous thromboembolism (VTE) is a common and preventable complication in critically ill patients with pulmonary embolism as the most preventable cause of in-hospital death, we assessed VTE risk and prophylaxis use in ICU patients from Dhaka City. METHODS: This cross-sectional study was conducted from January to June 2018 in two tertiary care hospitals of Dhaka. We prospectively included 130 patients with ICU admission for ≥24 h. The Padua risk assessment model (RAM) was used to assess VTE risk and patients with a score of ≥4 were classified as high risk. Chi-square tests and Student's t-tests were used for statistical analysis. RESULTS: High-risk status was significantly associated with advancing age and specific clinical predictors. Strong predictors for high-risk status included thrombophilia, immobilization and active malignancy. Despite high-risk status, only 28.57% received prophylaxis. Clinicians preferentially administered prophylaxis to elderly patients and those with acute infections, while overlooking predictors like malignancy. The overall in-hospital mortality was 15.4%. CONCLUSION: Nearly half of ICU patients are at high risk for VTE, yet prophylaxis utilization remains inadequate. Systematic implementation of mandatory risk assessment protocols is essential to bridge this clinical gap. CLINICAL TRIAL REGISTRATION: This study is a cross-sectional observational study involving no experimental intervention, treatment allocation or clinical trial procedures. Accordingly, clinical trial registration was not required or applicable for this study design.