Evaluation of Practice Pattern of Vte Prophylaxis in Postoperative Patients

Abstract

Venous thromboembolism (VTE) is one of the common complications in surgical patients. Venous thromboembolism (VTE), which is manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant cause of death, disability, and discomfort. With the various evidence based studies now we have a better understanding of the VTE/PE risk factors and preventive measures. However most of the hospitals and doctors fall short in implementing the knowledge while treating their patients. Hence the need for the present study to assess the practice pattern of VTE prophylaxis in surgical patients. MATERIALS AND METHODS: It's a retrospective study in which 100 patients were randomly selected from the operation theatre registry. Individual risk assessment was done and VTE prophylaxis given was recorded and then compared with the Caprini's VTE risk assessment model and suggested prophylaxis. RESULTS AND CONCLUSION: Appropriate VTE prophylaxis was given only in 42.03% of the postoperative patients (18.75% of low risk, 29.17% of moderate risk and 65.51% of high risk patients). The remaining 57.97% of patients were at increased risk of developing DVT and pulmonary embolism thus increasing the chances of morbidity and mortality. The prophylaxis was inadequate mainly in the moderate and low risk individuals. Hence there is a strong need for a standard hospital policy for VTE risk assessment and prophylaxis in surgical patients. KEYWORDS: Evaluation of practice pattern of VTE prophylaxis in postoperative patients. INTRODUCTION:Venous thromboembolism (VTE) is one of the common complications in surgical patients. 1 Venous thromboembolism (VTE), which is manifested as deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant cause of death, disability, and discomfort. The risk for VTE in surgical patients depends both on patient related factors and the type of surgery. 1,2 The commonly used guidelines for VTE risk assessment and prophylaxis are Caprini's VTE risk assessment model and American College of Chest Physicians (ACCP) consensus guidelines for VTE prophylaxis. Use of LMWH, pneumatic compression stockings or graded compression stockings have greatly reduced the incidence of VTE and thereby reducing the morbidity and mortality. 2 Pulmonary embolism (PE) is now the most common cause of preventable death in surgical patients.With the various evidence based studies now, we have a better understanding of the VTE risk factors and preventive measures. The high incidence of postoperative VTE and the availability of effective methods of prevention mandate that thromboprophylaxis should be considered in every surgical patient. However most of the hospitals and doctors fall short in implementing the knowledge while treating their patients. 3,4,5 Hence the need for the present study to assess the practice pattern of VTE prophylaxis in surgical patients.