A survey of extent of venous thfomboembolism prophylaxis among medical in-patients in Kenyatta National Hospital
Abstract
B a c k g r o u n d : Venous thromboembolism comprises both deep venous thrombosis (DVT) and
p u l m o n a r y embolism (PE). It accounts for approximately 10% of deaths in hospitals and has been
i d e n t i f i e d as the most preventable cause of death during hospitalization. Along with the mortality
a s s o c i a t e d with venous thromboembolism, long term complications, such as post thrombotic
s y n d r o m e , affect a patient's quality of life and result in significantly increased health care costs,
m o r b i d i t y and mortality.
Objective: The main purpose of this study was to carry out a baseline survey of extent of venous
thromboembolism prophylaxis among medical in-patients in Kenyatta national Hospital.
Setting: Kenyatta National Hospital, which is the largest teaching and referral centre in Kenya.
Study design: The study was a cross sectional study.
Methodology: The target population was the medical in-patients with high risks of developing
venous thromboembolism. One hundred and sixty eight (168) patients were selected by purposive
sampling from medical in patients. Data was collected using venous thromboembolism
prophylaxis risk assessment tool,and analysed by SPSS
Results: Of the 168 patients studied, (40%) were not given prophylaxis, (52%) got prophylaxis
and 8% had contraindications to chemical prophylaxis. Prevalence of VTE was 18.5% and the
gender ratio was similar 1:1. The drugs used were heparin (65.6%), enoxaparin 18.3%, warfarin
9.7%, warfarin and heparin concurrently used were 6.5%. No patient was put on non
pharmacological prophylaxis.
Conclusion: The prevalence of venous thromboembolism in Kenyatta National Hospital which
stands at 18.5% is higher than in the ones documented in literature that is 10-13% .The extent of
provision of VTE prophylaxis is still low at 52%. Of the population that required prophylaxis
only 52% were given while a big proportion 40% were left out. There are no non
pharmacological interventions being given to patients having contraindications to chemical
prophylaxis this left them prone to development of VTE. Active bleeding and uncontrolled
hypertension were the major contraindications to pharmacological prophylaxis
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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