Abstract:
Abstract
Background: Venous thromboembolism includes deep vein thrombosis and pulmonary
embolism. It is the 3
rd
leading cause of death from cardiovascular causes after myocardial
infarction and stroke. There is established evidence of cost effectiveness of preventing
venous thromboembolism. Moreover, there are different guidelines on the prevention of
venous thromboembolism however prevention practice in Ethiopia is not well studied in
orthopaedic surgery patients.
Objectives: To evaluate the prevention practice of venous thromboembolism and its
associated factors among orthopaedic surgery patients at university of Gondar comprehensive
and specialized Hospital
Method: A hospital based cross-sectional study was conducted among systematically
selected orthopaedics surgery patients. A Caprini risk assessment model was used to identify
risk factors. American college of chest physician 2012 VTE guideline was used to determine
appropriateness of prevention practice. Data were collected by interview, reviewing medical
records using structured and pretested questionnaire. Collected data was entered using Epidata
7
and
exported
to
SPSS
version
25.
Variables
having
association
in
the
bivariate
logistic
regression
(p<0.25)
was
entered
to
multivariate
logistic
regressions model and p value ?0.05
were used to claim statistical significance.
Result: From a total of 375 study subjects majority (88.3%) were males and the mean age
was 29 ± 10.4 years. The mean venous thromboembolism risk score was 7.7± 2.9. Of these
309 patients who have indication to receive venous thromboembolism prophylaxis, only 122
(39.4%) received pharmacologic prevention practice. Unfractionated heparin was the most
widely used thromboprophylaxis regimen. Overall less than half (46.4%) of participants were
received appropriate venous thromboembolism prevention practice. Multivariable logistic
regression analysis revealed that having a restricted type of physical activity [AOR=9.73
(95% CI 2.0-45.7, p= 0.004)], being bed ridden [AOR= 8.86 (95%CI 2.0-39.2, p= 0.01)] and
having ASA classification score of >3 [AOR= 9.6 (95% CI 1.7-52.1, p=0.009)] were
associated with inappropriate VTE prevention practice.
Conclusion: Despite the majority of patients at orthopaedic surgical patients were at risk of
developing venous thromboembolism, prevention practices remains underutilized at
university of Gondar comprehensive and specialized hospital. Hence, a concerted effort has
to be made to reduce contributing factors and improve utilization of thromboprophylaxis.
Key words: Venous thromboembolism, pulmonary embolism, thromboprophylaxis,
prophylaxis, orthopaedics, Gondar
