Venous thromboembolic disease (VTE) is a nosological group that mainly includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Indeed, between 70% and 80% of PEs are complications of deep vein thrombosis of the lower limbs [1] . The incidences are quite inhomogeneous between these different countries, ranging from 0.48 to 1.60 events/1000; they vary with age and can reach 5/1000 after 75 years [2] . In studies conducted in Benin, Cameroon, Ivory Coast and Mali, the hospital prevalence was 8.3%; 1.6%; 0.95%; 4.95% [3] - [6] . The often difficult diagnosis, the significant morbidity and mortality with medium and long-term sequelae make it a public health problem. This led us to initiate this work which aimed to determine the prevalence of VTE and to identify the different risk factors (FDR) responsible for thromboembolic events in patients in the Intensive Care Unit.

This is a descriptive study over a period of 1 year with prospective data collection from May 1, 2023 to April 30, 2024. This study took place in the Intensive Care Unit of the Gabriel Toure University Hospital in Bamako and covered all the files of patients of both sexes and all ages hospitalized for the managment of a medical or surgical pathology.

We admitted 627 patients, including 6 cases of venous thromboembolic disease (VTE), giving an overall hospital prevalence of 0.96% and a specific prevalence of isolated pulmonary embolism (PE) and the association of pulmonary embolism (PE) and deep vein thrombosis (DVT) were 0.64% and 0.16%, respectively. The mean age was 49.67 ± 17.58 years, ranging from 30 to 71 years, and the sex ratio was 0.2 ( Figure 1 ), with a female predominance. Housewives accounted for 33.3%.

The transient risk factors were prolonged immobilization ≥ 05 days (05 cases) 83.3%, major general surgery (01 case) 16.7%, spinal cord injury (01 case) 16.7%, central venous catheter (04 cases) 66.6% including 03 approaches in the femoral position. The permanent risk factors were obesity (04 cases) 66.6%, age (3 cases) 50%, high blood pressure (HTA) (3 cases) 50%, cancer (01 case) 16.7% ( Table 1 ).

The main clinical signs were dyspnea 100%, tachycardia 33.3% and chest pain 33.3%, Homans sign + increased local heat (01 case) 16.7% ( Table 2 ).

The diagnoses retained were pulmonary embolism (PE) alone (04 cases) 83.3%, deep vein thrombosis (DVT) alone (01 case) 16.7% and the association PE + DVT

(01 case) 16.7% ( Figure 2 ).

On imaging, the obstruction of the pulmonary artery was bilateral in (03 cases) 60% ( Table 3 ).

In addition to general resuscitation measures, all patients were placed on simple oxygen therapy with a simple mask. High-flow oxygenation (HFO) was initiated in (02 cases) and 02 patients were intubated and ventilated. Vasopressor amines such as dobutamine + noradrenaline and noradrenaline alone were initiated in (02 cases). For anticoagulant treatment, 83.3% of patients were placed on direct oral anticoagulants (DOACs) and 16.7% on low molecular weight heparin (LMWH). The average length of stay was 7.3 ± 3.33 days with extremes of 4 to 13 days and the case fatality of (03 cases) 50% of which (02 cases) 66.67% had sPESI ≥ 2 ( Table 4 ).

The prevalence of venous thromboembolic disease was 0.96% this result is close to that of Bertrand et al. [5] in Ivory Coast 0.95% and is lower than those of Denakpo et al. in Benin [3] 8.3%, Owono Etoundi et al. [4] in Cameroon 1.6%, Coulibaly et al. [6] in Mali 4.95%; our result can be explained by the fact that the diagnosis of (PE) is difficult despite the progress of diagnostic means, these difficulties are reported in the literature found in the literature [7] [8] . The average age of the patients was 49.67 ± 17.58 years this result is close to that by Owono Etoundi et al. [4] in Cameroon, Coulibaly et al. and Menta et al. [9] in Mali who found respectively 50.61 ± 25 years, 54 ± 17.79 years and 46.46 ± 21 years. The incidence of venous thromboembolic events increases with age, which is an independent thromboembolic risk factor. This risk is all the more important as there is an increased incidence of associated comorbidities (surgical interventions, immobility, or cancer) with age [10] . The sex ratio of 0.2 with a female predominance is found in studies [4] [6] [11] [12] .

Prolonged bed rest was the most frequently found risk factor 83.3% followed by central venous catheter 66.6% and obesity 66.6%. Obesity and prolonged bed rest are found in the literature as risk factors for VTE [13] - [15] . The predominant clinical manifestations of DVT were inflammatory edema associated with positive Homans sign 50% this result is close to that of Menta et al. in Mali [9] the literature confirms that edema of the lower limbs is the sign of DVT [16] . Dyspnea was the symptom of PE 100% of cases this result is similar to Coulibaly et al. in Mali [6] . The diagnoses retained were pulmonary embolism alone 83.3%, pulmonary embolism and deep vein thrombosis 16.7% and deep vein thrombosis alone 16.7%. The anticoagulant treatment was based on direct oral anticoagulants (DOAC) 83.3% mainly in accordance with the recommendations of the literature [16] [17] . The average length of stay 7.3 ± 3.3 days with extremes of 4 to 13 days, mortality of (03 cases) 50%, of which (02 cases) 66.67% had sPESI ≥ 2 this relationship PESI score.

The diagnosis and management of venous thromboembolic disease remains difficult. The female sex was the most affected, with prolonged bed rest as the main risk factor. The evolution remains marked by a significant morbidity mortality.