The Prevalence of Coagulopathy and Associated Factors Among Adult Type II Diabetes Mellitus Patients Attending the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Abstract

Introduction

Diabetes mellitus is a heterogeneous disorder of metabolism which results hyperglycemic-related atherothrombotic complications. These complications are the leading cause of death in diabetes mellitus patients. Therefore, this study was aimed to determine the prevalence of coagulopathy and associated factors among adult type II diabetes mellitus patients attending at University of Gondar comprehensive specialized hospital.

Methods

A facility-based cross-sectional study was conducted among 357 study participants. A questionnaire and a data collection sheet were used to collect the sociodemographic and clinical data, respectively. About 6mL of venous blood samples were collected for coagulation tests and complete blood count. For prolonged coagulation tests, a mixing test was performed. Data were entered into EpiInfo and exported to SPSS for statistical analysis. Then, descriptive statistics were done. A binary and multivariable logistic regression model was used to identify the associated factors. P-value <0.05 was considered as statistically significant.

Results

In this study, 357 study participants were included. Of them, 52.1% (186) and 80.7% (288) were females and urban residences, respectively. The prevalence of coagulopathy was 26.6% (95% CI: 22.1, 31.5%). Out of this, 12.3% and 8.7% showed shortened PT and aPTT, respectively. In addition, the prevalence of prolonged PT and aPTT were 5.6% and 3.9%, respectively. From the prolonged PT and aPTT, the prevalence of factor deficiency was 95% and 92.8%, respectively. Being female (AOR = 2.06; 95% CI: 1.11–3.85%), abnormal BMI (AOR = 1.94; 95% CI: 1.08–3.50), and educational status of high school (AOR = 0.26; 95% CI: 0.10–0.83%) were significantly associated with hypercoagulation.

Conclusion

Coagulopathy is an important public health problem among type II diabetes mellitus patients. Being female and having abnormal BMI were associated with hypercoagulation. Therefore, regular monitoring of coagulation parameters is vital to reduce the consequence of coagulopathy.

Keywords:

• coagulopathy
• mixing study
• type II diabetes mellitus
• Gondar
• Ethiopia

Abbreviations

AOR, adjusted odds ratio; aPTT, activated partial thromboplastin time; BMI, body mass index; CBC, complete blood count; COR, crude odds ratio; DM, diabetes mellitus; EDTA, ethylene diamine tetra acetic acid; GP, glycoprotein; IDF, International Diabetic Federation; NPP, normal pooled plasma; PPP, platelet poor plasma; PT, prothrombin time; T2DM, type II diabetes mellitus; UoGCSH, University of Gondar Comprehensive Specialized Hospital.

Data Sharing Statement

All data supporting these findings is contained within the manuscript.

Ethical Considerations

This study was conducted based on the Declaration of Helsinki. The study was conducted after ethical clearance was issued by the Ethical Review Committee of the School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, the University of Gondar (Ref. No. SBLS/2746/2021). A permission letter was obtained from the UoGCSH. Informed written consents were obtained from each patient and the findings were kept confidentially. The confidentiality of the data was protected by only using codes for specimens and results and no personal identification was used. In case of abnormal results, it was informed to their medical doctors to get adequate treatment.

Acknowledgments

First of all, we would like to thank the Department of Hematology and Immunohematology, the School of Biomedical and Laboratory Sciences, the University of Gondar. Next, we acknowledge the University of Gondar Comprehensive Specialized Hospital administrative office for their willingness during the data collection. Finally, we would like to extend our gratitude to the study participants for their voluntary and cooperative participation.

Author Contributions

All authors participated in this study by conception of the study, data collection, feeding, performing the statistical analysis, drafting the manuscript, and read and edit the manuscript. All authors read and gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest for this work and declare that there is no conflict of interest regarding the publication of this manuscript.

Additional information

Funding

The authors received no specific funding for this work.