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Venous thromboembolism: risk factors and prophylaxis assessments in al sulaimaniyah versus london hospitals

Author: 
Noralhuda Ahmed Hamzah, Hiwa K. Saaed and Dhafer Ibrahim Hasan
Subject Area: 
Health Sciences
Abstract: 

Background: Venous thromboembolism (VTE) that includes deep vein thrombosis (DVT) and pulmonary Embolism(PE) is the major cause of mortality and morbidity in hospitalized patients, and It is often under diagnosed due to lack of information on VTE risk and prophylaxis. International recommendations suggested that active monitoring of VTE prophylaxis can improve the quality of it is practice in Hospitals and prevent death (Bottaro and Emery, 2012; Dorfman and Chan, 2006). Aim of the study: Study aimed to: 1) Assess the prevalence of VTE risk in acute hospital care setting in AL-Sulaimaniyah, 2) Determine proportion of at-risk patients receiving prophylaxis, 3) Assess the type of prophylaxis measures used and compare it with London Hospitals, 4) Implement an Internal prophylaxis Guideline in Kurdistan to put a positive impact on patients safety and lower the incidence of VTE occurrence in hospitals. Hoping to be depended by Iraqi health system. Patients and Methods: The current cross sectional study was carried out in two parts on 350 patients; 1st part conducted in AL-Sulaimaniyah Hospitals including Medical, General Surgery, and Orthopedic Teaching Hospitals on 250 patients from December 2012 to March 2013, and 2nd part was conducted in London Hospitals including Medical, General Surgery, Cardiovascular, Plastic and Orthopedic on 100 patients, from April to May 2013. Risk factors profile and total risk score determined are stratified in four risk groups based on Caprini Scoring Risk Assessment Model. Low risk (from 0-1point), Moderate risk (2 point), Higher risk (from 3-4 point), Highest risk (from 5 point and more). Descriptive statistics (numbers and percentage) were calculated for all variables, as well as analytical statistics was done to find the relations between variables by using fisher exact and Chi square test. A p-value < 0.05 was considered as significant. Results: Patients in AL-Sulaimaniyah Hospitals revealed that most of the patients were at highest risk score > 5, and only small percentage of them receiving prophylaxis (31%) The differences between prophylaxis measures used in two cities regarding most types of measurements in two specialty medical and surgical were highly significant (P value of all <0.001). Conclusion: Because lack of prophylaxis measures and non-implementing a Unique National Guideline like that done in London, the results of the study showed that the risks for DVT and PE were high in patients of AL-Sulaimaniyah Hospitals.

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