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Presentation Details
| Venous Thromboembolism in Internal Medicine Inpatients: A One-Year Pilot Study of Prevalence, Patient Characteristics, and Survival Outcomes from Turkey. Bulent Kantarcioglu1, 3, Sultan Gozde Temiz2, Ayse Nilgun Kul1, Jawed Fareed3, Gulbuz Sezgin2. 1University of Health Sciences, Sancaktepe Sehit Prof.Dr.Ilhan Varank Training and Research Hospital, Department of Internal Medicine, Division of Hematology, Istanbul, Turkey.2University of Health Sciences, Sancaktepe Sehit Prof.Dr.Ilhan Varank Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey.3Loyola University Chicago, Department of Pathology & Laboratory Medicine, Cardiovascular Research Institute, Health Science Division, Maywood, IL, USA |
Abstract
Introduction: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), represents the third leading cause of cardiovascular mortality. Although the development and progression of VTE are driven by complex pathophysiological mechanisms, accumulating evidence suggests the pivotal role of inflammation in its pathogenesis. In this pilot study, we evaluated the prevalence, clinical characteristics, and survival outcomes of patients with VTE who were admitted to the internal medicine unit over a one-year period. We also assessed the predictive value of the neutrophil-to-lymphocyte ratio (NLR), red cell distribution width-to-albumin ratio (RDW/Albumin), and C-reactive protein-to-albumin ratio (CRP/Albumin) for 30-day mortality. Materials and Methods: The electronic medical records of patients diagnosed with VTE who were admitted to the Internal Medicine Unit of Prof. Dr. Feriha Öz Emergency Hospital between July 2024, and June 2025 were retrospectively reviewed. Data on patient demographics, vital signs, clinical symptoms, comorbidities, laboratory findings, VTE risk factors, and clinical outcomes were collected. The NLR, RDW/Albumin, and CRP/Albumin were calculated for each patient. Statistical differences between the DVT and PE groups were analyzed using the Mann–Whitney U test or Student’s t-test, as appropriate based on data distribution. Receiver operating characteristic (ROC) curve analysis and multivariable logistic regression were performed to evaluate NLR, RDW/Albumin, and CRP/Albumin as predictors of 30-day mortality. Results: Among 66,789 total hospital admissions during the study period, 3,993 were to the Internal Medicine Unit. A total of 86 patients were diagnosed with VTE, including 67 cases of DVT and 19 cases of PE, corresponding to an incidence of approximately 2.15% among internal medicine admissions. This incidence is markedly higher than that in the general population, where the annual incidence of VTE is approximately 0.1–0.2%, and is consistent with reported rates of 1–2% among hospitalized patients, highlighting the increased risk of VTE in this setting. No statistically significant differences were observed between the DVT and PE groups regarding patient demographics, comorbidities, or laboratory findings, except for vital signs and clinical symptoms. Thirty-day mortality was observed in 27.9% of patients, which was mainly due to the high burden of comorbidities; 34.9% had active metastatic cancer, and the median Charlson Comorbidity Index was 7 (IQR: 4.0-9.0). ROC curve analysis demonstrated that NLR, RDW/Albumin, and CRP/Albumin were significant predictors of 30-day mortality. The optimal cutoff values were 7.60 for NLR, 5.60 for RDW/Albumin, and 19.90 for CRP/Albumin (Figure 1). In multivariable logistic regression analysis, RDW/Albumin > 5.60 was the strongest independent predictor of 30-day mortality [odds ratio (OR): 8.53; 95% confidence interval (CI): 2.83–25.68], followed by CRP/Albumin > 19.90 [OR: 7.47; 95% CI: 2.22–25.09] and NLR > 7.60 [OR: 3.23; 95% CI: 1.17–8.89] (Figure 2). Conclusion: In this pilot study, we observed an increased risk of VTE in our community hospital setting, underscoring the importance of awareness of VTE in Turkey. Although the study sample was small, predictors such as RDW/Albumin, CRP/Albumin, and NLR may be useful for risk stratification in these patients. Further studies with larger cohorts are warranted to validate these findings.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.