Abstract #1: Presented at the “International Conference on Hematology & Blood Disorders”
Prevalence and risk factors for Thromboembolic events in adult outpatient population
Introduction: With >600,000 deaths due to cardiovascular disease and 200,000+ deaths due to pulmonary embolism in the United States annually, accurate diagnosis, treatment and preventive measures at all levels are mandatory. Research suggests that haemostatic and thrombotic factor are added risk factors for thromboembolic event and stroke. Blood coagulation, inflammation, and immune response are intricately linked and there is scarce literature regarding the mechanism these risk factors mediate the disease.
Purpose: Early risk-identification will improve the quality of patient care and dissemination of information to the patients and healthcare providers will result in early prevention and improved outcomes.
Method: This is a retrospective cohort of high risk pulmonary and thromboembolic patients in private practice setup. Data was collected from medical records for early risk assessment and diagnosis in patients seeking health care in a medical clinic at San Angelo, Texas.
Results: Out of 400 patients 37% have moderate risk (230-500 ng/mL ), and 15.5% have high risk (>500) of thromboembolic events. Multinomial logit models with forward selection and backward elimination methods were employed for moderate and elevated risk patients. Age has 5% increase in adjusted relative risk ratio (RRR) for every year increase (P=0.006) and BMI has about 4% for every unit increase (P=0.09) among the moderate risk patients. Obstructive sleep apnea is having a 266% relative risk of moderate level increase in D-dimer after adjusting for all covariates (P=0.028). Hispanic has 2.34 times higher relative risk ratios among the high risk patients (P=0.037). Factor VIII exhibit significant relationship with outcome for both moderate as and high risk patients with (P=0.03) and (P=0.001) respectively.
Conclusion: Hispanic, older, heavy weight, patients who were diagnosed with obstructive sleep apnea and had high blood level of factor VIII had significantly higher levels of D-dimer. Identification of uncommon risk factors for thromboembolic event prediction, beyond established vascular risk factors is very vital to assess the individual risk of thrombosis and promote more targeted prophylactic and therapeutic options. Based on this new information we can develop and advance policies to improve prevention, early detection, and control of thromboembolic events, a significant contributor to morbidity and mortality. Additional large prospective studies and analysis of existing clinical data at hospitals and clinics are required to further delineate the underlying pathology.