Long-term Risk of Stroke After New-Onset Atrial Fibrillation in Sepsis Survivors: A 2-Year Follow-Up Study.

BACKGROUND: Cardiovascular complications such as new-onset atrial fibrillation (NOAF) are common in sepsis and are known to increase the risk of in-hospital mortality and stroke. However, only a handful of studies have evaluated the long-term risk of stroke after NOAF in sepsis survivors. As part of our efforts to address this issue, we conducted the first-ever follow-up study in a developing country evaluating the long-term risk of stroke for sepsis survivors following NOAF. Methods: This retrospective study evaluated all adult patients admitted at the Aga Khan University Hospital between July 2019 and December 2019 with the diagnosis of sepsis. Data was collected from medical records of the included patients. Outcome measures included in-hospital mortality and ischemic stroke within 2 years. Results: Seven hundred thirty patients were included in the study; 415 (57%) were males and 315 (43%) females; mean age was 59.4 ± 18 years. 59 (8%) patients developed NOAF. The risk of stroke within 2 years in sepsis survivors was 3.5%. Six out of 30 (20%) patients in the atrial fibrillation (AF) group developed stroke, whereas 11 out of 448 (2%) patients in the non-AF group developed stroke. NOAF was associated with an increased risk of ischemic stroke within 2 years (OR = 6.6; 95% CI, 2.3-12.8; P = <.001). Conclusion: We conclude that AF occurred frequently in sepsis patients and was also associated with a 6-fold increase in the risk of ischemic stroke within 2 years. Reliable interventions for identifying high-risk patients for ischemic stroke are still poorly characterized, and this study may serve as a basis for more extensive multicenter studies to identify patients at high risk for ischemic stroke in the aftermath of septic AF and develop precise interventions for preventing it.

Predictors of clinical outcomes in patients with sepsis: A retrospective study from a tertiary care hospital in Pakistan.

OBJECTIVE: To assess associations between various clinic-demographic factors and clinical outcomes among patients treated for sepsis. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of all patients aged >18 years diagnosed with sepsis from January to December 2019. Multivariable logistic regression was used to evaluate independent associations between predictors and outcomes. Data was analysed using R packages. RESULTS: Of the 1,136 patients, 621(54.6%) were male and 515(45.3%) were female. The overall mean age was 59.05±16.91 years. Female gender (odds ratio: 1.029; 95% confidence interval: 1.03-1.64) was found to be an independent predictor of septic shock, while hypertension (odds ratio0.75; 95% confidence interval: 0.59-0.95) emerged as a protective factor. Chronic kidney disease (odds ratio: 1.539; 95% confidence interval: 1.14-2.07) was an independent predictor of prolonged length of stay, while older age appeared to be protective (odds ratio: 0.98; 95% confidence interval: 0.98-0.99). Mortality was associated with a significantly lower odds of Escherichia coli on culture (odds ratio: 0.26; 95% confidence interval: 0.12-0.54). CONCLUSIONS: Independent associations were found between specific patient characteristics and adverse clinical outcomes.

Tackling a deadly global phenomenon: sepsis induced coagulopathy: A narrative review.

Sepsis is a potentially fatal illness marked by organ failure and the two main causes of which are shock and disseminated intravascular coagulation. Multi-organ dysfunction in sepsis is mediated by the inflammatory cytokine storm, while sepsis induced coagulopathy is mediated and accelerated by activation of pro-coagulative mechanisms. Regardless of the severity of sepsis, disseminated intravascular coagulation is a potent predictor of mortality in septic patients. Additionally, oxidative stress in sepsis causes renal ischaemia and eventually acute kidney injury. The first and foremost goal is to initiate resuscitation immediately, with treatment mainly focussing on maintaining a balance of coagulants and anticoagulants. A simpler and more universal diagnostic criteria is likely to improve studies on the spectrum associated with sepsis.

Pulmonary barotrauma as a complication of mechanical ventilation for management of COVID-19 associated acute respiratory distress syndrome (CARDS).

Objectives: To identify that incidence of pulmonary barotrauma secondary to mechanical ventilation for the management of acute respiratory distress syndrome associated with coronavirus-disease-2019, and to compare it with the incidence of pulmonary barotrauma trauma secondary to mechanical ventilation associated with all the other causes. METHODS: The retrospective case-control study was conducted at the Aga Khan University Hospital, Karachi, and comprised data from October 2020 to March 2021 of patients who underwent mechanical ventilation. The data was divided into two groups. Data of acute respiratory distress syndrome associated with coronavirus-disease-2019 was in group 1, and that of acute respiratory distress syndrome associated with any other cause in control group 2. Medical records were reviewed to obtain demographic and clinical data, while the institutional picture archiving and communication system was used to review radiological images. Data was analysed using SPSS 24. RESULTS: Of the 261 cases, 115(44%) were in group 1; 87(75.6%) males and 28(24.3%) females. There were 146(56%) controls in group 2; 96(65.7%) males and 50(34.2%) females. There were 142(54.4%) subjects aged >60 years; 61(43%) in group 1 and 81(57%) in group 2. The incidence of pulmonary barotrauma in group 1 was 39(34%) and 8(5.5%) in group 2 (p<0.0001). CONCLUSIONS: Mechanical ventilation in the management of acute respiratory distress syndrome associated with coronavirusdisease- 2019 was found to be associated with a significantly higher incidence of pulmonary barotrauma than acute respiratory distress syndrome associated with any other cause.

Interleukin-6 (IL-6) as a Predictor of Clinical Outcomes in Patients with COVID-19.

BACKGROUND: Interleukin-6 (IL-6) has been known to be involved in immune regulation, inflammatory response, and metabolism. It is also recognized as the major cause to underscore the pathology of severe COVID-19 patients. However, it remains to be seen if IL-6 is superior to other inflammatory biomarkers in ascertaining clinical severity and mortality rate for COVID-19. This study aimed to determine the value of IL-6 as a predictor of severity and mortality in COVID-19 patients and compare it with other pro-inflammatory biomarkers in the South Asian region. METHODS: An observational study was conducted, including all adult SARS-CoV-2 patients who had undergone IL-6 testing from December 2020 to June 2021. The patients' medical records were reviewed to collect demographic, clinical, and biochemical data. Other pro-inflammatory biomarkers apart from IL-6 included Neutrophils to Lymphocyte Ratio (NLR), D-dimer, C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), and procal-citonin for analysis. SPSS version 22.0 was utilized. RESULTS: Out of the 393 patients who underwent IL-6 testing, 203 were included in the final analysis with a mean (SD) age of 61.9 years (12.9) and 70.9% (n = 144) were male. Fifty-six percent (n = 115) subjects had critical disease. IL-6 levels were elevated (> 7 pg/mL) in 160 (78.8%) patients. Levels of IL-6 significantly correlated with age, NLR, D-dimer, CRP, ferritin, LDH, length of stay, clinical severity, and mortality. All the inflammatory markers were significantly increased in critically ill and expired patients (p < 0.05). The receiver operator curve showed that IL-6 had the best area under the curve (0.898) compared to other pro-inflammatory biomarkers for mortality with comparable results for clinical severity. CONCLUSIONS: Study findings show that though IL-6 is an effective marker of inflammation and can be helpful for clinicians in recognizing patients with severe COVID-19. However, we still need further studies with larger sample size.

Evaluation of MONOFER-induced hypersensitive reactions: A retrospective cohort study.

Iron deficiency is the most common cause of anaemia. Over the years, various IV preparations of iron have been developed, including Monofer® (Iron isomaltoside 1000), that showed a remarkable reduction in the occurance of hypersensitivity reactions. The main aim of the study was to evaluate the severity and extent to which hypersensitivity reactions occur after the administration of IV iron isomaltoside 1000 in an Asian population. Multistage sampling was adopted for this study. The overall sample size was 864. The mean age of the participants was 55.29 ±18.44 years. The results depicted that 63 (7.29%) of the entire participants faced hypersensitivity reactions after IV administration. A total of 43 (68.25%) participants who experienced hypersensitivity reactions showed clinical symptoms within one hour, 11(17.46%) showed reaction in 1-3 hours and 9 (14.29%) showed in > 3 Hours. The majority of the studied population showed significant improvement only after the administration of Pheniramine maleate, while only a few of them received Hydrocortisone.

SARS-CoV-2 induced coagulopathy and potential role of anticoagulation: Scoping review of literature.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can vary on a spectrum of asymptomatic disease to rarer manifestations like hypercoagulability especially among elderly patients admitted in the intensive care unit (ICU) and those with preexisting comorbidities. The exact mechanism behind this phenomenon is still unclear, however studies have shown an association with elevated cytokines and severe inflammatory response which encompasses this disease. Hypercoagulability can be limited to the lungs, or present as systemic manifestations of arterial and venous thrombosis leading to mortal outcomes. Thus, careful evaluation of risk factors should be performed by physicians and treatment with anticoagulants should be modified accordingly. All Coronavirus Disease 2019 (COVID-19) in-patients should receive thromboprophylactic therapy, with increased dosages administered to patients with increased disease severity or those with a high risk. D-dimer levels and sepsis-induced coagulopathy (SIC) score aid in identifying high risk patients and predicting outcome. This article highlights the pathophysiology behind hypercoagulability, its clinical associations and discusses therapeutic modalities to combat this fatal consequence of SARS-CoV-2.

Etiology, clinical characteristics, and outcome of infective endocarditis: 10-year experience from a tertiary care center in Pakistan.

This study was conducted to assess the clinical characteristics, causative agents, complications, and outcomes of infective endocarditis (IE) among patients presenting to our tertiary care center over the last decade. This retrospective cohort study included all adult patients admitted to the Aga Khan University Hospital with the diagnosis of IE over a ten-year period from 2010 to 2020.  Outcomes variables included complications during hospitalization, surgical intervention, mortality, and length of stay. We identified a total of 305 cases out of which 176 (58%) were males and 129 (42%) were females. The mean age of the patients was 46.9±18.8 years. 95 (31%) had prosthetic valves in place. Staphylococcus aureus was isolated in 54 (39%) patients followed by coagulase-negative Staphylococcus in 23 (17%). Echocardiography revealed vegetations and abscesses in 236 (77%) and 4 (1%) patients, respectively. The most common valvular complication was mitral valve regurgitation found in 26 (9%) patients, followed by tricuspid valve regurgitation in 13 (4%) patients and aortic valve regurgitation in 11 (3%) patients. Furthermore, 81 (27%) patients suffered from heart failure and 66 (22%) from a stroke during hospitalization. The mean hospital length of stay was 10.4 ± 10.6 days. 64 (21%) patients required surgical repair and the overall mortality rate was 25%. Prosthetic valve endocarditis (OR = 3.74, 95% CI = 2.15-6.50, p<0.001), chronic kidney disease (OR = 2.51, 95% CI = 1.15-5.47, p=0.036), previous stroke (OR = 2.42, 95% CI = 1.18-4.96, p=0.026), and ischemic heart disease (OR = 3.04, 95% CI = 1.50-6.16, p=0.003) were significantly associated with an increased risk of mortality. In conclusion, our study provided valuable data on the clinical characteristics and outcomes of patients with IE in a developing country. S. aureus was the most common causative agent. Heart failure and stroke were the most common complications. The presence of prosthetic valves, history of chronic kidney disease, ischemic heart disease and previous stroke were associated with a significantly increased risk of mortality. Surgical management was not associated with improved outcomes.

Factors predicting mortality among patients with COVID-19 associated hospital acquired pneumonia: insights from a tertiary care center.

Hospital acquired pneumonia (HAP) is a severe and dangerous complication in patients admitted with COVID-19, causing significant morbidity and mortality globally. However, the early detection and subsequent management of high-risk cases may prevent disease progression and improve clinical outcomes. This study was undertaken in order to identify predictors of mortality in COVID-19 associated HAP. A retrospective study was performed on all patients who were admitted to a tertiary care center with COVID-19 associated HAP from July 2020 till November 2020. Data was collected on relevant demographic, clinical and laboratory parameters to determine their association with in-hospital mortality; 1574 files were reviewed, out of which 162 were included in the final study. The mean age of subjects was 59.4±13.8 and a majority were male (78.4%). There were 71 (48.3%) mortalities in the study sample. Klebsiella pneumoniae (31.5%) and Pseudomonas aeruginosa (30.2%) were the most common organisms overall. Clinically significant growth of Aspergillus sp. was observed in 41 (29.0%) of patients. On univariate analysis, several factors were found to be associated with mortality, including male gender (p=0.04), D-dimers >1.3 mg/L (p<0.001), ferritin >1000 µg/mL (p<0.001), LDH >500I.U/mL (p<0.001) and procalcitonin >2.0 µg/mL (p<0.001). On multivariate analysis, ferritin >1000ng/mL, initial site of care in Special Care Units or Intensive Care Units, developing respiratory failure and developing acute kidney injury were factors independently associated with mortality in our patient sample. These results indicate that serum ferritin levels may be a potentially useful biomarker in the management of COVID-19 associated HAP.

Association of Chest Xray (CXR) findings with outcomes in COVID-19 Patients.

Objective: To investigate chest radiography findings in suspected coronavirus disease-2019 patients in a tertiary care setting. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of coronavirus disease-2019 cases admitted to the tertiary care centre from March 1 to March 30, 2020. A predesigned proforma was used to gather data, including demographics, like age and gender, co-morbidities, presenting symptoms and chest radiography findings during the admission. Length of stay and mortality were the outcome measures. Data was analysed using SPSS 22. RESULTS: Of the 154 suspected cases, 46(29.8%) tested positive for coronavirus disease-2019; 29(63%) males and 17(37%) females with a mean age of 50.7±19.1 years. Abnormal chest radiography was noted in 25(54.3%) cases, with bilateral pulmonary infiltrates being the most common finding 19(41.3%). Mortality was the outcome in 7(28%) of these cases, and the mean length of hospital stay was 9.3±7.3 days. Abnormal chest radiography findings were associated with an increased risk of mortality (p=0.009) and a longer hospital stay (p=0.017). Conclusion: Abnormal chest radiography findings were frequently seen in coronavirus disease-2019 patients and were also associated with increased risk of mortality and prolonged hospital stay.

Clinical spectrum of sarcoidosis in patients at a tertiary care hospital, Pakistan: Ten-year follow-up study.

OBJECTIVE: To identify the local patterns of manifestations, organ involvement other than lungs, diagnostic tools and treatment regimens related to patients of sarcoidosis. Methods: The retrospective study was conducted from November 1, 2019, to February 28, 2020, at the Aga Khan University Hospital, Karachi, and comprised data of sarcoidosis patients who needed hospitalisation between 2009 and 2019. The entire clinical spectrum was noted based on organ involvement. Data was analysed using SPSS 21. RESULTS: Of the 80 patients, 53(66.3%) were women. The overall mean age at diagnosis was 52.0±13.5 years. Pulmonary sarcoidosis was found in 60(75%) patients, while 13(16.3%) had extrapulmonary manifestations, and 6(8.8%) had both pulmonary and extrapulmonary involvement. None of the patients had hypercalcaemia, while antinuclear antibodies were positive in 2 (18.2%) patients. In terms of treatment, 75(93.8%) patients received corticosteroids. Acute exacerbation of interstitial lung disease was the most common reason of hospitalisation 16(20%). Mortality was the outcome in 11(14.7%) cases. CONCLUSIONS: Sarcoidosis was found to be more prevalent in women aged 50 years and above. A quarter of patients had extrapulmonary manifestation, while interstitial lung disease was the most common complication.

Risk factors for intensive care unit admission and mortality among adult meningitis patients.

OBJECTIVE: To assess the risk factors for intensive care unit admission and inpatient all-cause mortality among adult meningitis patients. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised of patients of either gender aged ≥18 years diagnosed with bacterial, viral, or tuberculous meningitis between July 2010 and June 2019. Multivariable logistic regression analyses were used to explore independent predictors of inpatient mortality and intensive care unit admission. Data was analysed using SPSS 24. RESULTS: Of the 929 patients with suspected meningitis, 506(54.5%) had confirmatory diagnosis. Of them, 303(59.9%) were males. The overall median age of the sample was 47.0 years (interquartile range: 33.0 years). The most common aetiology was bacterial meningitis 324(64%), followed by viral meningitis 141(27.9%). Incidence of inpatient mortality was 53(10.5%), while 75(14.8%) patients required intensive care unit admission. Tuberculous aetiology, intensive care unit admission, concurrent encephalitis, hydrocephalus, inpatient neurosurgery, and longer length of hospital stay were predictors of mortality (p<0.05). Non-indication of blood culture was found to be associated with reduced risk of mortality (p<0.05). For intensive care unit admission, diabetes mellitus, presentation with seizure, imaging suggestive of meningitis, and inpatient neurosurgery were associated with higher risk of admission, while hypertension, presentation with headache, viral aetiology and non-indication of blood culture reduced the risk (p<0.05). CONCLUSIONS: Adult meningitis patients tend to have poor expected outcomes, and their management strategies should be planned accordingly.

Progression of Acute Kidney Injury to Chronic Kidney Disease in Sepsis Survivors: 1-Year Follow-Up Study.

BACKGROUND: Despite the fact that septic acute kidney injury (AKI) is considered to be reversible, it can result in permanent kidney damage. Unfortunately, there is a scarcity of long-term follow-up studies highlighting progression to chronic kidney disease (CKD) in sepsis survivors. To address this issue, we conducted this study to assess the development of CKD in sepsis patients with AKI, and to identify risk factors associated with its development. METHODS: This retrospective cohort study evaluated medical records of patients admitted at the Aga Khan University Hospital between January-December 2017 with the diagnosis of sepsis and subsequent development of acute kidney injury (AKI). One-year follow-up data was then analyzed to determine whether the AKI resolved or progressed to chronic kidney disease. RESULTS: 1636 sepsis patients were admitted during the study period, out of which 996 (61%) met the inclusion criteria. 612 (61%) developed AKI during the admission. Mortality rate in the AKI group was 44% (n = 272). After 1 year, 47 (19%) patients eventually went on to develop CKD and 81% (n = 195) recovered fully. Risk factors for development of CKD were age ≥ 60 years (p = <0.001), diabetes (p = <0.001), hypertension (p = 0.001) and history of ischemic heart disease (p = <0.001). CONCLUSION: Mortality rates in sepsis are alarmingly high and even those patients who manage to survive are at risk of developing permanent organ dysfunction. Our study revealed that almost one fifth of all septic AKI survivors went on to develop chronic kidney disease within 1 year, even when AKI was not severe. We recommend that clinicians focus on early recovery of renal function, irrespective of AKI severity, and ensure robust follow-up monitoring to reduce long term morbidity and mortality associated with this devastating illness.

Correlation of serum calcium with severity of acute ischaemic stroke.

Stroke results in the death of around 6.5 million people annually with a majority of these occurring in developing countries. Serum calcium has been hypothesised to play a significant role in causing ischaemic stroke. This retrospective observational study was conducted to determine the correlation, if any, between serum calcium and the severity of acute ischaemic stroke in our population. Two hundred and seventy-nine patients admitted with acute ischaemic stroke were enrolled in the study. Of the 279 patients 162 (58%) were male and mean age was 62.4 ± 3.8 years. Characteristics of stroke patients were compared with stroke severity. Mean albumin corrected serum calcium and Scandinavian stroke severity score was 9.1 (± 5.6) and 33.67 (± 15.2), respectively. Hypertension and mean GCS on admission were significantly associated with increased stroke severity score. However, no correlation was observed between serum calcium and severity of acute ischaemic stroke.

Knowledge and attitude towards identification and management of sepsis among resident physicians in a tertiary care teaching hospital in Pakistan.

This study was conducted to determine the compliance and knowledge of sepsis guidelines among resident physicians in a tertiary care hospital of a developing country. A self-structured validated questionnaire was prepared to evaluate compliance and knowledge of the Surviving Sepsis Campaign (SSC) guidelines. A total of 76 resident physicians completed the questionnaire; out of these, 51 (67%) were from Internal Medicine department and 25 (33%) were from Emergency Medicine department of the Aga Khan University Hospital, Karachi. A total of 71 (93%) participants claimed to be aware of the SSC guidelines but only 20 (26%) considered themselves very knowledgeable on the subject. Thirty-five (46%) physicians claimed that they were using the guidelines regularly. We concluded that the overall knowledge and compliance of sepsis guidelines was suboptimal. This emphasises the need for increased awareness and teaching of sepsis and SSC guidelines to improve patient outcomes in developing countries.

Prevalence of risk factors of acute kidney injury in a tertiary care hospital in Pakistan.

The objective of this study was to determine the prevalence of preventable risk factors of acute kidney injury in a tertiary care hospital in Pakistan. All patients admitted at Aga Khan University Hospital, Karachi with diagnosis of acute kidney injury were included out of which 134 were selected via random sampling. Patients with existing CKD were excluded. Data was then collected retrospectively from medical records of these patients. Mean age was 60±11.7 years while mean serum creatinine on admission was 2.4±1.3 (mg/dl). Sepsis played a role in almost half of the patients [60 (45%)]. Other factors included diarrhoea [23 (17%)], nephrotoxic drug use [25 (19%)] and cardiac pathology [24 (18%)]. It was found that most cases of AKI were due to preventable factors (infections, diarrhoea, and drug toxicity) and concerted efforts to eliminate them would be vital in reducing mortality caused by AKI in developing countries.

Journey of medication reconciliation compliance in a lower middle-income country: a retrospective chart review.

OBJECTIVE: There were three main objectives of the study: to determine the overall compliance of medication reconciliation over 4 years in a tertiary care hospital, to compare the medication reconciliation compliance between paper entry (initial assessment forms) and computerised physician order entry (CPOE), and to identify the discrepancies between the medication history taken by the physician at the time of admission and those collected by the pharmacist within 24 hours of admission. METHODS: This study was conducted at a tertiary care hospital in a lower middle-income country. Data were gathered from two different sources. The first source involved retrospective data obtained from the Quality and Patient Safety Department (QPSD) of the hospital, consisting of records from 8776 patients between 2018 and 2021. The second data source was also retrospective from a quality project initiated by pharmacists at the hospital. Pharmacists collected data from 1105 patients between 2020 and 2021, specifically focusing on medication history and identifying any discrepancies compared with the history documented by physicians. The collected data were then analysed using SPSS V.26. RESULTS: The QPSD noted an improvement in physician-led medication reconciliation, with a rise from 32.7% in 2018 to 69.4% in 2021 in CPOE. However, pharmacist-led medication reconciliation identified a 25.4% (n=281/1105) overall discrepancy in the medication history of patients admitted from 2020 to 2021, mainly due to incomplete medication records in the initial assessment forms and CPOE. Physicians missed critical drugs in 4.9% of records; pharmacists identified and updated them. CONCLUSION: In a lower middle-income nation where hiring pharmacists to conduct medication reconciliation would be an additional cost burden for hospitals, encouraging physicians to record medication history more precisely would be a more workable method. However, in situations where cost is not an issue, it is recommended to adopt evidence-based practices, such as integrating clinical pharmacists to lead medication reconciliation, which is the gold standard worldwide.

Consensus statements for influenza awareness, prevention, and vaccination in Pakistan.

INTRODUCTION: Influenza is a serious underestimated viral infection in Pakistan and influenza vaccination and vaccination awareness are low. The current work aimed to develop consensus on influenza epidemiology, prevention, vaccination, and awareness in Pakistan. METHODOLOGY: A systematic literature search was conducted to develop recommendations on influenza vaccines in Pakistan. Experts' feedback was incorporated using the modified Delphi method. A three-step process was used, with 18 experts from different specialties from Pakistan who participated in voting rounds to achieve a minimum 75% agreement level. RESULTS: Pakistan has a low-immunization-rate and is susceptible to serious influenza outbreaks and influenza-related complications. Influenza circulates year-round in Pakistan but peaks during January and February. The subtype A/H1N1 is predominant. The experts urged vaccination in all individuals ≥ 6 months of age and with no contraindications. They highlighted special considerations for those with comorbidities and specific conditions. The experts agreed that the inactivated influenza vaccine is safe and efficient in pregnant women, immunocompromised, and comorbid respiratory and cardiovascular patients. Finally, the experts recommended conducting promotional and educational programs to raise awareness on influenza and vaccination. CONCLUSIONS: This is the first regional consensus on influenza and influenza vaccination in Pakistan with experts' recommendations to increase influenza vaccination and decrease influenza cases and its associated detrimental effects.

Analysis of Readmissions Due to VTE-Using Hospital Data to Improve VTE Prophylaxis Compliance: A Quality Improvement Project.

Venous thromboembolism (VTE) is a preventable cause of mortality and morbidity. We performed a retrospective analysis of patient records to identify those readmitted with a diagnosis of VTE within 6 months of the primary admission. The records were evaluated to see whether thromboprophylaxis had been provided to patients at high risk for VTE. A total of 360 hospital encounters between August 1, 2018, and August 31, 2019, with VTE, 57 (16%) encounters were readmissions with a primary diagnosis of deep vein thrombosis within 180 days of their primary stay. A high proportion (44%) of these readmissions were within the first 30 days. 3% (n = 9) of patients developed pulmonary embolism; 35 (61%) did not receive thromboprophylaxis on their primary stay. Thromboprophylaxis is often not utilized appropriately in healthcare settings. Our study showed substantial incidence of hospital readmissions due to VTE which is consistent with prior studies conducted globally. A more stringent adherence to the protocol along with risk stratification may lower rates of VTE admission and reduce associated morbidity and mortality.