Incidence, Predictors and Outcome of Venous Thromboembolism Among Patients Undergoing Major Operation at Bugando Medical Centre. Mwanza, Tanzania
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TextPublisher number: Wurzburg Road 35, BMC Premises, Post Code: 33102: P. O Box 1464, Mwanza – Tanzania: Phone: +255 28 298 3384: Fax: +255 28 298 3386: Email: vc@bugando.ac.tz : Website: www.bugando.ac.tz Language: English Publication details: Mwanza, Tanzania: Catholic University of Health and Allied Sciences [CUHAS - Bugando] : 2020Description: xii; 87 Pages; Includes References and AppendicesSubject(s): Summary: Abstract:
Background: Venous thromboembolism (VTE) is a disorder that includes deep venous thrombosis and pulmonary embolism. This study aimed to determine the incidence, predictors, and outcome of venous thromboembolism among patients undergoing major operations at Bugando Medical Centre.
Methods: Longitudinal study was conducted in the department of surgery at Bugando Medical Centre from February to July 2020. We recruited 400 patients undergoing major surgery, all study participants were screened for VTE using modified Caprini for DVT and modified Wells score for PE. Patients with high score from Caprini and Wells score were subjected to doppler ultrasonography and computerized tomography pulmonary angiography to confirm the diagnosis. Patient who had sudden death prior to these investigations underwent postmortem to confirm the diagnosis. Data were analyzed using STATA version 13.A p-value of <0.05 was significant
Results: The cumulative incidence of VTE was 11.8% with median age of 38 [IQR, 28-61] years. Age ≥45 years, body mass index ≥25, hypertension and prolonged duration of immobilization were the main predictors of VTE. Among 381 patients’ (43.0%, n=164) patients were postoperatively classified as having a high risk of developing VTE. Of these, (27.7%, n=45) developed VTE (fisher’s exact p<0.001). Out of 45 patients with VTE, 14 patients’ died resulting in a mortality rate of 31.1%. Mortality was associated with male gender (X2=6.1329, P=0.013). Only (17.7%, n=29) of high-risk patients received VTE prophylaxis, however, prophylaxis was protective against development of VTE (fisher exact P=0.023) which was statistically significant.
Conclusion: The study has demonstrated that VTE is not uncommon among postoperative patients at BMC and is associated with high mortality rate. At Bugando Medical Center, VTE prophylaxis is significantly underutilized. Therefore, implementation of appropriate prophylaxis measures to all patients at risk of developing VTE is of paramount importance in order to lower the risk of VTE.
| Item type | Current library | Collection | Status | Barcode | |
|---|---|---|---|---|---|
| POSTGRADUATE DISSERTATIONS | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | NFIC | 1 | PD0383 |
Abstract:
Background: Venous thromboembolism (VTE) is a disorder that includes deep venous thrombosis and pulmonary embolism. This study aimed to determine the incidence, predictors, and outcome of venous thromboembolism among patients undergoing major operations at Bugando Medical Centre.
Methods: Longitudinal study was conducted in the department of surgery at Bugando Medical Centre from February to July 2020. We recruited 400 patients undergoing major surgery, all study participants were screened for VTE using modified Caprini for DVT and modified Wells score for PE. Patients with high score from Caprini and Wells score were subjected to doppler ultrasonography and computerized tomography pulmonary angiography to confirm the diagnosis. Patient who had sudden death prior to these investigations underwent postmortem to confirm the diagnosis. Data were analyzed using STATA version 13.A p-value of <0.05 was significant
Results: The cumulative incidence of VTE was 11.8% with median age of 38 [IQR, 28-61] years. Age ≥45 years, body mass index ≥25, hypertension and prolonged duration of immobilization were the main predictors of VTE. Among 381 patients’ (43.0%, n=164) patients were postoperatively classified as having a high risk of developing VTE. Of these, (27.7%, n=45) developed VTE (fisher’s exact p<0.001). Out of 45 patients with VTE, 14 patients’ died resulting in a mortality rate of 31.1%. Mortality was associated with male gender (X2=6.1329, P=0.013). Only (17.7%, n=29) of high-risk patients received VTE prophylaxis, however, prophylaxis was protective against development of VTE (fisher exact P=0.023) which was statistically significant.
Conclusion: The study has demonstrated that VTE is not uncommon among postoperative patients at BMC and is associated with high mortality rate. At Bugando Medical Center, VTE prophylaxis is significantly underutilized. Therefore, implementation of appropriate prophylaxis measures to all patients at risk of developing VTE is of paramount importance in order to lower the risk of VTE.
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