COMPLINACE WITH VENOUS THROMBOEMBOLISM PROHYLAXIS AT LAUTOKA HOSPITAL

Researchers: Raj A1, Sharma V2, Kubuabola I3.
Researcher Affiliations
1College of Medicine, Nursing and Health Science, Fiji National University, Lautoka city, Fiji.
2 College of Medicine, Nursing and Health Science, Fiji National University, Suva city, Fiji.
3 College of Medicine, Nursing and Health Science, Fiji National University, Suva city, Fiji.
Key Words: Lautoka, Venous thromboembolism (VTE), risk factors, thromboprophylaxis
Introduction: Venous Thromboembolism (VTE) is an important healthcare problem with high morbidity, mortality and associated health care costs. VTE is a preventable occurrence and often under diagnosed. The proportion of hospitalized patients at risk of VTE at Lautoka hospital is unknown. This study aims to assess the prevalence of VTE risk and the proportion of at risk patients receiving adequate prophylaxis.
Method: This crossectional study looked at surgical and nonsurgical (medical) patients, who were above 18 years of age, admitted at Lautoka hospital and met the study criteria. Data was collected through patient interviews, physical examination and review of patients charts. A total of 328 patients risk of VTE and the use of prophylaxis was assessed as per the American College of Chest physicians (ACCP) guidelines 2012.
Results: Of the 328 patients studied 122 (37.2%) were surgical and 206 (62.8%) nonsurgical. Overall, 84 (68.9%) surgical patients were at risk of VTE, however only 17 (23.3%) received prophylaxis. Of the 100 (48.5%) at risk nonsurgical patients, 12 (16.9%) received ACCP recommended prophylaxis. The overall compliance to thromboprophylaxis was 15.4%. Dosage regimen for all patients receiving pharmacological prophylaxis was standard at low dose unfractionated heparin (LDUH) 5000 units twice daily while none of the at risk patients with contraindications to pharmacological prophylaxis received mechanical prophylaxis.
Discussion: Despite at risk population at Lautoka hospital being similar to the global ENDORSE trial, there was major underutilization of prophylaxis. This study confirms the need for increasing awareness about VTE risk and risk assessment and implementing measures to increase appropriate use of thromboprophylaxis.