Venous Thromboembolic Disease Among the Lebanese Population: A Retrospective Observational Study

Abstract

Aims: To assess the characteristics and risk factors for patients presenting with venous thromboembolic disease (VTE) in Lebanon. Methods: This was a retrospective, multicenter study that was conducted between the years of 2018-2019 in Lebanon. All medical charts with positive findings for VTE were included. Data on baseline characteristics, risk factors, signs and symptoms of disease, diagnostic findings, treatment, readmission and mortality rates at 1 year were collected. Results: 1500 charts were reviewed. We included 132 confirmed diagnosis with deep vein thrombosis (DVT) or pulmonary embolism (PE). Out of 132 patients 43% were diagnosed with DVT, 42% with PE and 15% having both DVT and PE. Mean age was 61 years. Current smokers were 36%. Coronary artery disease was found in 19.5%, diabetes in 11%, atrial fibrillation in 10.5% and malignancy in 30% of the cases. Readmission rate within 1 year was 35%. In hospital mortality was 13% and one-year mortality was 22%. Characteristics of patients diagnosed with DVT vs patients diagnosed with PE were comparable. However, we noted that chronic kidney disease was more prevalent in patients with DVT than in patients with PE (25% vs 5% respectively; p- 0.002). Obesity was found less in patients with DVT than in patients with PE (2% vs 12% respectively; p-0.042). Patients with malignancy were diagnosed more with DVTs than with PE; however, the p-value was not statistically significant (39% vs 24% respectively; p-0.086). Patients with recent infection in the prior month of diagnosis was noted to be a predisposing factor for PE than for DVT (21% vs 9% respectively; p-0.04). Mortality within one year was significantly associated with male gender (p-0.009) and having a diagnosis of DVT+PE (p-0.005). Conclusion: Our study revealed a high burden of VTE in Lebanon. Malignancy and prior infection were a predisposing factor for VTE. The readmission rate and the one-year mortality were significantly elevated. Mortality was significantly associated with the diagnosis of combined DVT and PE at the same time.