Akhtar Ahmed Bilal, Mehdi Syed Raza, Khan Ahsun, Zahid Muhammad Toqeer, Abu Bakar Muhammad
Anesthesia and Critical Care, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
Surgery, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
Cureus. 2021 Jul 25;13(7):e16627. doi: 10.7759/cureus.16627. eCollection 2021 Jul.
Objective To determine the proportion of patients receiving venous thromboembolism (VTE) prophylaxis after oncological surgeries as per the hospital standards and its comparison with the international guidelines. Methodology In the month of September 2019, all patients after elective oncological surgeries were reviewed for VTE prophylaxis administration and education. Results were shared with the department of surgery and Hospital Quality and Patient Safety Department. Education was provided to the relevant staff and hospital policy for VTE prophylaxis was revised followed by a loop audit which was done in October 2020. The primary endpoint was to compare the proportion of patients receiving prophylaxis as per the hospital guidelines. Results Total 425 patients were included in this audit (209 in September 2019 and 216 in October 2020). Compliance with mechanical prophylaxis increased from 84.7 % to 98.6% and pharmacological prophylaxis improved from 39.7% (n=83) to 73.1% (n=158). Adherence to local protocols enhanced significantly from 1.9% (n=4) to 56.4% (n=122). The main cause of non-compliance was lack of risk assessment for VTE. Conclusion VTE prophylaxis can be improved by setting protocols in accordance with the international guidelines and local protocols. This can prevent significant morbidity and mortality in surgical patients as well as hospital costs.
目的 根据医院标准确定肿瘤手术后接受静脉血栓栓塞症（VTE）预防治疗的患者比例，并与国际指南进行比较。方法 在2019年9月，对所有择期肿瘤手术后的患者进行了VTE预防治疗及教育情况的审查。结果反馈给了外科以及医院质量与患者安全部门。对相关工作人员进行了培训，并修订了医院的VTE预防政策，随后在2020年10月进行了循环审核。主要终点是比较按照医院指南接受预防治疗的患者比例。结果 本次审核共纳入425例患者（2019年9月209例，2020年10月216例）。机械预防措施的依从性从84.7%提高到了98.6%，药物预防措施从39.7%（n = 83）提高到了73.1%（n = 158）。对当地方案的遵守情况从1.9%（n = 4）显著提高到了56.4%（n = 122）。不遵守的主要原因是缺乏VTE风险评估。结论 通过根据国际指南和当地方案制定规程，可以改善VTE预防情况。这可以预防手术患者的重大发病和死亡情况，以及降低医院成本。
