Plasma D-Dimer Levels and Venous Thromboembolism Risk Among Hospitalised Patients in a North West Nigerian Hospital: A Prospective Cohort Study

This study prospectively evaluates plasma D-dimer levels as predictors of venous thromboembolism (VTE) risk in hospitalised adult patients at Bayero University Teaching Hospital, Kano State, North West Nigeria. VTE is a significant but underdiagnosed complication of hospitalisation in Nigeria, and D-dimer measurement provides an accessible haemostatic risk indicator, yet prospective VTE incidence data with D-dimer profiling are absent from Northern Nigerian literature. A prospective cohort of 300 consecutively hospitalised adult patients across medical, surgical, and orthopaedic wards was enrolled. D-dimer was measured at admission and day 7. Wells probability scoring was applied for VTE risk stratification. Lower limb compression ultrasonography was performed in all patients at day 14 or earlier if clinically indicated. VTE was confirmed in 8.7 percent of the cohort, comprising predominantly deep vein thrombosis (72%) and pulmonary embolism (28%). D-dimer above 500 nanograms per millilitre at admission showed 94 percent sensitivity and 67 percent specificity for VTE in multivariate analysis adjusted for Wells score, age, and immobility. Orthopaedic patients had the highest VTE incidence (22.4%). Thromboprophylaxis was used in only 19 percent of high-risk patients. The study establishes the diagnostic performance of D-dimer in this population and recommends systematic VTE risk assessment on admission, routine D-dimer measurement in high-risk wards, and thromboprophylaxis protocol implementation at Bayero University Teaching Hospital. Keywords: D-dimer, venous thromboembolism, hospitalised patients, thromboprophylaxis, Kano State.