Teferi Mekonen Banchamlak, Shibabaw Molla Tewodros, Fentahun Bekalu Abaynesh, Gemedi Jara Abdisa, Naji Gebremariam Saron, Nigussie Abrha Nega, Sitotie Redie Adugnaw, Abdela Muche Esileman
Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Hosp Pract (1995). 2025 Feb;53(1):2503697. doi: 10.1080/21548331.2025.2503697. Epub 2025 May 12.
Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, is the third leading cause of death from cardiovascular conditions. Very limited research has been done on venous thromboembolism prevention in clinical practice in orthopedic surgery patients in Ethiopia. Thus, this study aims to evaluate the prevention practice against venous thromboembolism and its identified associated factors among orthopedic surgery patients.
A cross-sectional study was conducted among orthopedic surgery patients. The appropriateness of prevention practice was evaluated using the 2012 VTE guidelines from the American College of Chest Physicians. This guideline helps as a blueprint to determine whether the available prevention strategies are in line with the standard recommendation for providing better patient care. Data was entered using Epidata 7 and exported to SPSS version 25. In a multivariate logistic regression model, a p-value ≤0.05 was used to claim statistical significance.
From a total of 375 study subjects, the majority (88.3%) were males, and the mean age was 29 ± 10.4 years. Overall, 176 (46.4%) participants received appropriate venous thromboembolism prevention practices. Unfractionated heparin was the most widely used thromboprophylaxis regimen. Having restricted mobility (low level of physical activity) [AOR = 9.73 (95% CI 2.0-45.7, = 0.004)], being bedridden [AOR = 8.86 (95% CI 2.0-39.2, = 0.01)] and having ASA classification score of >3 [AOR = 9.6 (95% CI 1.7-52.1, = 0.009)] were associated with inappropriate VTE prevention practice.
Our study revealed that only 46.4% orthopedic surgical patients at risk of developing venous thromboembolism received adequate VTE prevention practices. Factors that contribute to inadequate prevention include low levels of physical activity, bedridden, and higher ASA classification scores. Hence, by addressing these risk factors and increasing awareness and application of standard VTE prevention protocols, it's possible to reduce contributing factors, improve the utilization of thromboprophylaxis, and lower the rate of VTE.
静脉血栓栓塞，包括深静脉血栓形成和肺栓塞，是心血管疾病导致死亡的第三大主要原因。在埃塞俄比亚，针对骨科手术患者临床实践中静脉血栓栓塞预防的研究非常有限。因此，本研究旨在评估骨科手术患者预防静脉血栓栓塞的实践情况及其已确定的相关因素。
对骨科手术患者进行了一项横断面研究。使用美国胸科医师学会2012年的VTE指南评估预防措施的适宜性。该指南有助于作为一个蓝图，以确定现有的预防策略是否符合提供更好患者护理的标准建议。数据使用Epidata 7录入并导出到SPSS 25版本。在多变量逻辑回归模型中，p值≤0.05被用来判定具有统计学意义。
在总共375名研究对象中，大多数（88.3%）为男性，平均年龄为29±10.4岁。总体而言，176名（46.4%）参与者接受了适当的静脉血栓栓塞预防措施。普通肝素是使用最广泛的血栓预防方案。行动受限（身体活动水平低）[调整后比值比（AOR）=9.73（95%置信区间2.0 - 45.7，p = 0.004）]、卧床不起[AOR = 8.86（95%置信区间2.0 - 39.2，p = 0.01）]以及美国麻醉医师协会（ASA）分级评分>3[AOR = 9.6（95%置信区间1.7 - 52.1，p = 0.009）]与不适当的静脉血栓栓塞预防措施相关。
我们的研究表明，只有46.4%有发生静脉血栓栓塞风险的骨科手术患者接受了充分的静脉血栓栓塞预防措施。导致预防不足的因素包括身体活动水平低、卧床不起以及较高的ASA分级评分。因此，通过解决这些风险因素并提高对标准静脉血栓栓塞预防方案的认识和应用，有可能减少促成因素，提高血栓预防的利用率，并降低静脉血栓栓塞的发生率。
