000			06715nam a22004097a 4500
001			CUHAS/MMED/6000225/T/16
003			CUHAS/MMED/6000225/T/16
005			20240422143401.0
008			210821b |||||||| |||| 00| 0 eng d
028			_bWurzburg Road 35, BMC Premises, Post Code: 33102:
028			_b P. O Box 1464, Mwanza – Tanzania:
028			_bPhone: +255 28 298 3384:
028			_bFax: +255 28 298 3386:
028			_bEmail: vc@bugando.ac.tz :
028			_b Website: www.bugando.ac.tz
035			_aCUHAS/MMED/6000225/T/16
040			_bEnglish _cddc
041			_aEnglish
100			_aAllen Gabriel Kangalawe _d[Male] _922853 _eCUHAS/MMED/6000225/T/16
210			_aABBREVIATIONS _bAIDS Acquired Immunodeficiency Syndrome ASA American Association of Anesthesiologist BMC Bugando Medical Centre BMI Body Mass Index CREC CUHAS-BMC Research and Ethics Committee CTPA Computerized Tomography Pulmonary Angiography CUHAS Catholic University of Health and Allied Science CVD Cardiovascular Disease CXR Chest X-Ray DM Diabetes Mellitus DUS Doppler Ultrasonography DVT Deep Venous Thrombosis ECG Electrocardiogram EMD Emergency Medicine Department ENT Ear Nose and Throat GOPD Gynecological Outpatients Department HIV Human Immunodeficiency Virus IQR Interquartile Range LMWH Low Molecular Weight Heparin MOPD Medical Outpatients Department PE Pulmonary Embolism PI Principle Investigator SOPD Surgical Outpatients Department STATA South Texas Art Therapy Association UFH Unfractionated heparin US United States VTE Venous Thromboembolism
222			_aOPERATIONAL DEFINITIONS For the purposes of this study the following were defined as follows:- _bOutcome of surgery: was defined as patients with radiological and/or clinical evidence VTE (i.e. DVT or PE or both) and death following a major surgery.
222			_aOPERATIONAL DEFINITIONS For the purposes of this study the following were defined as follows:- _bDuration of surgery: Is the total time between (cutting time) knife to skin, to the closure of skin, and for endoscopic surgery is the time duration from introduction of scope to the patient and removal of scope from the patient after completing the surgery
222			_aOPERATIONAL DEFINITIONS For the purposes of this study the following were defined as follows:- _bMajor surgery/operation: Is any open or laparoscopic intervention occurring in operating theatre requiring regional or general anaesthesia lasting more than 45minutes associated with an expected blood loss >500mls, at least one night of admission in hospital, opening of body cavity, resection of organ, extensive soft tissue resection or manipulation, joint replacement, open reduction and internal fixation and spine, thoracic, vascular or intracranial surgery.
222			_aOPERATIONAL DEFINITIONS For the purposes of this study the following were defined as follows:- _bPulmonary embolism: Is a dislodged blood clot from the deep veins in the lower extremities or pelvis which travels through the circulation and lodges into the pulmonary vessels and manifest with chest pain, difficulty in breathing, coughing +/-blood, fast breathing and heart rate, low blood pressure and fever occurring within 4 weeks or more after major operation.
222			_aOPERATIONAL DEFINITIONS For the purposes of this study the following were defined as follows:- _bDeep vein thrombosis: Is a clinical and/or radiological presentation of the clotted blood in the deep veins of the lower extremities or pelvis occurring within 4 weeks or more following a major operation and manifest with unilateral or bilateral lower limb swelling, pain, tenderness, warm skin and bluish or reddish skin coloration around the affected area.
222			_aOPERATIONAL DEFINITIONS For the purposes of this study the following were defined as follows:- _bVenous thromboembolism: Is a clinical and/or radiological presentation of the clotted blood in the deep veins of the lower extremities or pelvis with or without pulmonary manifestation, occurring within 4 weeks or more following a major operation.
245			_aIncidence, Predictors and Outcome of Venous Thromboembolism Among Patients Undergoing Major Operation at Bugando Medical Centre. Mwanza, Tanzania
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences [CUHAS - Bugando] : _c2020
300			_axii; 87 Pages
300			_aIncludes References and Appendices
520			_aAbstract: 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.
600			_xSurgery _929082
700			_aMahalu, William _919950
700			_aRambau, Peter _920966
700			_aVihar Kotecha _922736
942			_2ddc _cMP
999			_c18522 _d18522