Assessment of venous thromboembolism risk and prohylaxis practices among elective surgical patients at Kenyatta national hospital

Abstract

Background Venous thromboembolism (VTE) is a common and preventable complication of surgery. It’s risk is determined by various factors with surgery being one of them. Thromboprophylaxis is effective and safe in surgical patients and should be used routinely used according to the available guidelines. There is scarcity of data on the distribution of risk factors and prophylaxis practices among non-orthopedic surgical patients at KNH. Aim The aim of the study was to assess the incidence of VTE risk in elective non orthopedic surgery patients using Caprini score and determine the proportion of the at-risk patients receiving VTE prophylaxis. Design Prospective descriptive study. Materials and method The study was carried out in surgical units in Kenyatta National Hospital (KNH) over a period of four months upon ethical approval. Elective non orthopedic surgical patients will be recruited into the study. Distribution of risk factors for VTE and coverage of prophylaxis in at-risk patients will be assessed using the Caprini VTE risk factor assessment tool. Consecutive sampling in patients who met the inclusion criteria was used to enroll them into the study. Data was collected in structured questionnaires and statistical analysis was performed using SPSS version 21. The statistical significant p-value of <0.05 was used. Results 61.3% of all elective surgical patients were at risk of VTE. Among the at-risk only 26.3 % received VTE prophylaxis. Prophylaxis measures were implemented in only 52 of 323 elective patients studied. The only 2 patients with the highest VTE risk patients received prophylaxis but only 25.1% of high risk and 35.6% of moderate risk patients received prophylaxis. xii Conclusion Surgical patients undergoing elective surgeries are not well protected against VTE. Thromboprophylaxis are rarely prescribed and guidelines are not adhered to. There is need for improved VTE risk assessment and prophylaxis practices in surgery patients.