Primary Thromboprophylaxis Among Surgical Patients in a Sub-Saharan Tertiary Health Institution

Mbah N

Department of Surgery, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Nigeria

^*Correspondance to: Mbah N 

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Abstract:

Background: Venous thromboprophylaxis aims at reducing avoidable morbidity, death and chronic ill health from hospital-associated Venous Thromboembolism (VTE). Reports indicate inadequate provision of primary thromboprophylaxis on surgical patients managed in most hospitals across Africa. Aim: To determine the level of Venous Thromboembolism (VTE) risk among adult surgical patients seen at the Chukwuemeka Odumegwu Ojukwu Teaching Hospital (COOUTH) Awka, Nigeria, evaluate the proportion of these patients who receive venous thromboprophylaxis and offer recommendations to optimize patients’ outcome. Methods: The Caprini model of VTE risk assessment was used prospectively to evaluate consecutive patients admitted into the adult surgical services of the COOUTH, Awka, Nigeria over a three month period (June 2023–August 2023). Results: Two hundred and forty-nine adult surgical patients were studied among whom 208 patients (83.5%) had a Caprini score of ≥ 3 indicating moderate risk or more for VTE. The males were 123/208, females 85/208; M:F ratio 1.4:1. The age range of the study population was 18 to 92 years, mean 51 years. Overall, only 59/208 (28.4%) patients at significant VTE risk received primary thromboprophylaxis. The medications used were enoxaparin (26/59 patients, 44.1%), dabigatran (21/59, 35.6%), clopidogrel (8/59 patients, 13.6%) and rivaroxaban in 4 (6.8%). None of the subjects received anti-embolism stockings or intermittent pneumatic compressions. Conclusion: A large number (84%) of adult patients hospitalized within the surgical services of the COOUTH are moderate to high risk for VTE. Standard primary thromboprophylaxis practice for these cases is low (28%). The routine use of hospital-based VTE risk assessment model and the provision of primary VTE prevention for the large number of patients at significant risk need to be strongly enforced in order to optimize patients’ outcome.

Keywords:

Thromboprophylaxis; Venous thromboembolism; Risk Factors; Clinical Practice Guideline

Cite the Article:

Mbah N. Primary Thromboprophylaxis Among Surgical Patients in a Sub- Saharan Tertiary Health Institution. World J Surg Surgical Res. 2023; 6: 1515..