Department of Surgery, Aga Khan Hospital, Dar es Salaam, Tanzania.
Department of Pharmacy, Aga Khan Hospital, Dar es Salaam, Tanzania.
Pan Afr Med J. 2022 Jun 29;42:160. doi: 10.11604/pamj.2022.42.160.28278. eCollection 2022.
venous thromboembolism is a complication among admitted medical and surgical patients. International guidelines recommend patients are assessed upon admission and appropriate thromboprophylaxis should be initiated. However, studies have shown that thromboprophylaxis for patients at risk of venous thromboembolism is underutilized.
this was a retrospective study conducted on hospitalized medical and surgical patients at Aga Khan Hospital Dar es salaam from January to June 2019. Patient's medical records were reviewed and data was collected for analysis of venous thromboembolism assessment and compliance with Caprini risk assessment model. The data was entered into statistical package for the social sciences (SPSS) 25 and categorized into risk groups, frequency of patients' demographic and clinical characteristics data was calculated and the main study outcomes were analyzed with Fisher´s exact test or Pearson chi-square test for categorical variables and student t-test for continuous variables. Regression analyses were done to identify significant risk factors where by P ≤ 0.05 was considered statistically significant.
compliance of venous thromboembolism assessment among medical and surgical patients was similar at 78% and 80%, respectively, with a baseline 22% of all admitted patients considered at risk of venous thromboembolism, hence needing thromboprophylaxis following the Caprini risk assessment modelscore. Thromboprophylaxis practices was identified at just 25% of at-risk individuals received pharmacological prophylaxis with enoxaparin; the most commonly used agent (92%). Identified risk factors for venous thromboembolism were advancing age (>60 years), history of prior major surgery, Major surgery lasting > 60 minutes, obesity, and immobilization.
risk assessment for venous thromboembolism should be emphasized upon admission of both surgical and medical patients. Adequate thromboprophylaxis should be prescribed upon identification of patients at risk.
静脉血栓栓塞症是住院内科和外科患者的一种并发症。国际指南建议在患者入院时进行评估，并启动适当的血栓预防措施。然而，研究表明，存在静脉血栓栓塞风险的患者的血栓预防措施未得到充分利用。
这是一项回顾性研究，于 2019 年 1 月至 6 月在达累斯萨拉姆 Aga Khan 医院对住院内科和外科患者进行。回顾患者的病历并收集数据，以分析静脉血栓栓塞评估和 Caprini 风险评估模型的依从性。将数据输入统计软件包（SPSS）25，并根据风险组进行分类，计算患者人口统计学和临床特征数据的频率，并使用 Fisher 确切检验或 Pearson 卡方检验分析主要研究结果，用于分类变量，学生 t 检验用于连续变量。进行回归分析以确定显著的危险因素，其中 P≤0.05 被认为具有统计学意义。
内科和外科患者的静脉血栓栓塞评估的依从性相似，分别为 78%和 80%，基线时所有入院患者中有 22%被认为存在静脉血栓栓塞风险，因此需要根据 Caprini 风险评估模型评分进行血栓预防。只有 25%的高危人群接受了依诺肝素的药物预防，这是最常用的药物（92%）。静脉血栓栓塞的危险因素为年龄增长（>60 岁）、既往重大手术史、手术时间超过 60 分钟、肥胖和固定不动。
应在外科和内科患者入院时强调静脉血栓栓塞的风险评估。应在识别出高危患者时开具适当的血栓预防措施。
