Venous thromboembolism prevention practice and associated factors among orthopedic surgical patients in Ethiopia: a cross-sectional study.

INTRODUCTION

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.

METHOD

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.

RESULT

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.

CONCLUSION

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.