10Sep 2017

EVALUATION OF VENOUS THROMBO-EMBOLISM PROPHYLAXIS IN PATIENTS UNDERGOING MAJOR ORTHOPEDIC SURGERIES (HIP & KNEE) IN EGYPT.

  • El Salam Hospital, Cairo, Egypt.
  • Ain Shams Specialized Hospital, Cairo, Egypt.
  • Nozha International Hospital, Cairo, Egypt.
  • El Hadra University Hospital, Alexandria, Egypt.
  • Abo Keer Specialized Hospital, Alexandria, Egypt.
  • Royal Hopsital, Alexandria, Egypt.
  • El Horea Hospital, Cairo, Egypt.
  • El Madeena El Tebya Hospital, Alexandria, Egypt.
  • Ibrahim Ebeid Hospital, Alexandria, Egypt.
  • El Hawamdeya Medical Centre, Giza, Egypt.
  • Giza International Hospital, Giza, Egypt.
  • Al Hadra University Hospital, Alexndria, Egypt.
  • El Masoura Educational Hospital, Mansoura, Egypt.
  • Mahmoud Hospital, Giza, Egypt.
  • Al Ahrar Hospital, Sharqia, Egypt.
  • Egypt Air Hospital, Cairo, Egypt.
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Venous thrombo-embolism (VTE) is a major health threat despite the availability of various prophylactic regimens with favourable benefit-risk ratio. Guidelines on thrombo-embolic disorders and their management are also available. However, there are still gaps between guidelines and real life clinical practice. Patients undergoing major orthopedic surgeries are at high risk of developing VTE. Our study aims to compare real life VTE prophylaxis received by patients to the recommendations set by international ACCP guidelines (2008) during hospitalization and after hospital discharge and to detect the possible reasons for discrepancies. The study was a local, multicenter, longitudinal, non-interventional study with 4-6 weeks follow-up for patients undergoing major orthopedic surgeries and included a total of 3 visits; admission visit, discharge visit, and a follow-up visit. Each of the twenty active wards recruited around 10 to 15 consecutive patients. When this study was conducted, data was compared to what was recommended by ACCP 2008 guidelines to assess compliance. Our results shows that real life VTE prophylaxis was compliant to ACCP 2008 guidelines in a majority of patients both during hospitalization (96.6%; 95% CI: 94.7, 98.6%) and after hospital discharge (73.3%; 95% CI: 68.4, 78.2%). Reasons for non-compliance to guidelines during hospitalization included late starting of VTE prophylaxis, not prescribing VTE prophylaxis and prescribing other anti-thrombotic agents not recommended by the guidelines. Reasons for post discharge non-compliance included no prophylaxis, longer or shorter prophylaxis and prescribing other anti-thrombotic agents not recommended by the guidelines. VTE prophylactic medications prescribed for patients who underwent major orthopedic surgery were compliant to ACCP 2008 guidelines during hospitalization and after hospital discharge.


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[Ahmed Hassan, Timour El Husseiny, Mahmoud El Sebaie, Ayman Soliman, Yousry Emad, Mohamed El Shafie, Ehab Shehata, Essam Al Abassi, Osama Mostafa, Abdallah Kaddah, Ahmed Morrah, Adel Wanas, Adham El Sharkawi, Osama El Shazli, Ahmed Galal, Mohamed Zaki, Sami Nafie, Magdy El Sayed and El Zaher Hasan. (2017); EVALUATION OF VENOUS THROMBO-EMBOLISM PROPHYLAXIS IN PATIENTS UNDERGOING MAJOR ORTHOPEDIC SURGERIES (HIP & KNEE) IN EGYPT. Int. J. of Adv. Res. 5 (Sep). 104-113] (ISSN 2320-5407). www.journalijar.com


Dr. Ahmad Hassan
Professor of orthopedicsurgery , Alexandria University Hospital

DOI:


Article DOI: 10.21474/IJAR01/5307      
DOI URL: http://dx.doi.org/10.21474/IJAR01/5307