The purpose of this research is to ascertain the prevalence of postoperative venous thromboembolism in the Department of Surgery at Anosiala University Hospital and to identify risk factors for developing postoperative venous thromboembolism using the Caprini Risk Assessment Model. From December 2017 to October 2019, this was a 22-month prospective cohort research conducted at Anosiala University Hospital. It included all adult patients over the age of 18 who were operated on in an emergency or on a planned basis by the Department of Surgery. This research included 662 participants. Within 30 days after surgery, the risk of venous thromboembolism was 0.3 percent. According to the overall Caprini score, 25.2 percent of patients were classified as having a low risk of venous thromboembolism, 25.2 percent as having a moderate risk, 29.5 percent as having a high risk, and 20.1 percent as having the greatest risk. Patients in the highest risk category (scoring 5) had a substantially increased chance of having venous thromboembolism after surgery (p = 0.0007). Only major open surgery was related with a statistically significant increase in postoperative venous thromboembolism (p = 0.028). Age 75 years, elective arthroplasty, and hip, pelvic, or leg fractures were not linked with postoperative venous thromboembolism statistically significantly (p> 0.05). Our findings indicate that the Caprini risk assessment model might be used successfully to avoid postoperative venous thromboembolism in surgical patients in Madagascar, since patients in the highest risk category had a considerably increased chance of developing postoperative venous thromboembolism.
Introduction: The recognition of perioperative blood loss as a factor in patient mortality and morbidity led to the operating room patient safety checklist recommended by the World Health Organization.
Methods: This was a prospective, descriptive study over a ten-month period from January to October 2019 including all the patients hospitalized in the Orthopedic Surgery and Traumatology department of the CHU Anosiala. All patients operated on for an orthopedic or trauma pathology were included in this study, patients having undergone percutaneous surgery were excluded and not included patients not operated on.
Results: One hundred and twelve patients were collected. The average age of the patients was 32.9 years, there is a male predominance with a sex ratio of 2.5. Screw-retained plate osteosynthesis was the most frequent intervention (29.5%) in traumatology, in Orthopedics the installation of the total hip arthroplasty (THA) (6.3%) and sequestrectomy (11.6%) in osteo-articular infection. The mean blood loss for the whole procedure was 508 milliliters (ml) of which in orthopedics, the placement of the total knee arthroplasty (TKA) had the highest mean loss (1630 ml) followed by THA and open reduction neglected dislocations with a respective loss of and 1101 ml and 623.3 ml. In trauma, screw-retained plate osteosynthesis of the femur was the most hemorrhagic with an average blood loss of 820.3 ml and in osteoarticular infections, sequestrectomy with an average loss of 596.2 ml.
Conclusion: The amount of blood loss in orthopedic and trauma surgery varies depending on the type of surgery performed. Arthroplasty, open reduction of a neglected dislocation, screw-retained femoral plate osteosynthesis and sequestrectomy were the most hemorrhagic type of procedure in the perioperative period
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