VENOUS THROMBOEMBOLISM RISK ASSESSMENT IN HOSPITALISED PATIENTS IN A TERTIARY CARE HOSPITAL IN PAKISTAN

Authors

  • Ajwad Farogh Shahida Islam Medical College, Lodhran-Pakistan
  • Noman Ullah Wazir Peshawar Medical College, Peshawar-Pakistan
  • Saima Mumtaz Federal Medical College Islamabad-Pakistan
  • Farzana Salman Peshawar Medical College, Peshawar-Pakistan
  • Ahsan Arif Shalamar Institute of Health Sciences, Lahore-Pakistan
  • Anam Umair Rawalpindi Institute of Cardiology, Rawalpindi-Pakistan

DOI:

https://doi.org/10.55519/JAMC-02-13243

Keywords:

Venous thromboembolism, Risk Assessment

Abstract

Background: Venous thromboembolism (VTE) ranks as the third most common cause of vascular death following myocardial infarction and stroke. VTE is a prevalent illness, particularly in the elderly, and is linked to a high recurrence rate, substantial healthcare costs, and reduced survival rates. The Objective of the study was to investigate the impact of using the VTE risk assessment (VTE-RA) tool and thromboprophylaxis (TP) on all adult patients hospitalized. Methods: This study was conducted at a single centre using a prospective cross-sectional design to compare data before and after an intervention at a tertiary referral hospital in Pakistan from May 2019 to February 2020. All adult inpatients over the age of 18 were eligible for inclusion. Results: A total of 1,200 patients were screened in the study. The majority of these patients were medical 701(58.42%) and 499(41.58%) were surgical. The mean age of patients was 59.02±1.40 years. The male patients were 690(57.55%) as compared with females were 510 (42.5%). The average stay in hospital was 8.01±1.11 days. At that time, there was no official RA instrument implemented. Researchers documented any written proof of RA in patients' medical records as "RA completed." 190(15.83%) out of all charts evaluated had a recorded VTE risk assessment. TP was prescribed to 450(37.5%) patients, which accounts for of the total. Risk factors for VTE in high-risk patients. Conclusion: VTE risk assessment, prescribing adequate thromboprophylaxis, and integrating it into practice is challenging. The majority of hospitalized patients investigated were at a high risk of having venous thromboembolism (VTE). The most prevalent risk factor for developing VTE is old age, however, only few hospitalized patients were actually given thromboprophylaxis.

Author Biographies

Ajwad Farogh, Shahida Islam Medical College, Lodhran-Pakistan

Associate Professor

Noman Ullah Wazir, Peshawar Medical College, Peshawar-Pakistan

 

Saima Mumtaz, Federal Medical College Islamabad-Pakistan

 

Farzana Salman, Peshawar Medical College, Peshawar-Pakistan

 

Ahsan Arif , Shalamar Institute of Health Sciences, Lahore-Pakistan

 

References

Albricker ACL, Freire CMV, Santos SND, Alcantara ML, Saleh MH, Cantisano AL, Teodoro JAR, Porto CLL, Amaral SID, Veloso OCG, Petisco ACGP, Barros FS, Barros MVL, Souza AJ, Sobreira ML, Miranda RB, Moraes D, Verrastro CGY, Mançano AD, Lima RSL, Muglia VF, Matushita CS, Lopes RW, Coutinho AMN, Pianta DB, Santos AASMDD, Naves BL, Vieira MLC, Rochitte CE. Joint Guideline on Venous Thromboembolism - 2022. Arq Bras Cardiol. 2022 Apr;118(4):797-857

Wendelboe, A. M. & Raskob, G. E. Global burden of thrombosis: epidemiologic aspects.Circ. Res. 118, 1340-1347 (2016).

Hong, J. et al. Incidence of venous thromboembolism in Korea from 2009 to 2013. PLoS ONE 13, e0191897 (2018).

Vázquez, F. J., Posadas-Martínez, M. L., Vicens, J., González Bernaldo de Quirós, F. & Giunta, D. H. Incidence rate of symptomatic venous thromboembolic disease in patients from a medical care program in Buenos Aires, Argentina: a prospective cohort. Thrombosis J. 11, 16 (2013).

Ho, W. K., Hankey, G. J. & Eikelboom, J. W. The incidence of venous thromboembolism: a prospective, community-based study in Perth, Western Australia. Med. J. Aust. 189, 144-147 (2008)

Tagalakis V, Patenaude V, Kahn SR, Suissa S. Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE Study Cohort. The American journal of medicine. 2013 Sep 1;126(9):832-e13.

Ongen G, Yılmaz A, Cirak AK, Ersoy CY, Erden F, Altıntaş F, Yıldırım C, Güven H, Demir A, Kaynar LE, Bastacı N. Venous thromboembolism risk and thromboprophylaxis among hospitalized patients: data from the Turkish arm of the ENDORSE study. Clinical and Applied Thrombosis/Hemostasis. 2011 Oct;17(5):539-45.

Stubbs MJ, Mouyis M, Thomas M. Deep vein thrombosis. BMJ. 2018 Feb 22;360:k351.

Hansrani V, Khanbhai M, McCollum C. The prevention of venous thromboembolism in surgical patients.Adv Exp Med Biol. 2017; 906:1-8. doi: 10.1007/5584_2016_100

Henke PK, Kahn SR, Pannucci CJ, Secemksy EA, Evans NS, Khorana AA, Creager MA, Pradhan AD, American Heart Association Advocacy Coordinating Committee. Call to action to prevent venous thromboembolism in hospitalized patients: a policy statement from the American Heart Association. Circulation. 2020 Jun 16;141(24):e914-31.

Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. Journal of thrombosis and thrombolysis. 2016 Jan;41:3-14.

Kearon C, Akl EA, Ornelas J, Blaivas A, Jimenez D, Bounameaux H, Huisman M, King CS, Morris TA, Sood N, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report.Chest. 2016; 149:315-352. doi: 10.1016/j.chest.2015.11.026

Hansrani V, Khanbhai M, McCollum C. The prevention of venous thromboembolism in surgical patients.Adv Exp Med Biol. 2017; 906:1-8. doi: 10.1007/5584_2016_100

Khan MI, O'Leary C, Silvary V, O'Brien A, Duggan C, O'Shea S. Current Practice of Hospital Acquired Thrombosis (HAT) Prevention in an Acute Hospital (a single centre cross sectional study Irish Medical Journal April 2017, Volume 110; Number 4

NICE clinical guidelines Venous thromboembolism: reducing the risk 92; Jan 2010

Khan MI, O'Leary C, O'Brien A, Lester L, Silvari V, Duggan C, O'Shea S. Hospital acquired thrombosis (HAT) prevention in an acute hospital; a single centre cross-sectional study. Irish Medical Journal. 2017;110(4).

Scaglione L, Piobbici M, Pagano E, et al. Implimenting guidelines for venous thromboembolism prophylaxis in a large Italian teaching hospital: lights and shadows. Haematologica 2005;90:678-84.

Collins R, Mac Lellan L, Gibbs H, MacLellan D, Flecthcer J. Venous Thromembolism Prophylaxis: The role of the nurse in changing practice and saving lives (2009). Australian Journal of Advanced Nursing 27(3)

Adamali, H; Suliman, AM; Zaid, H; Suliman, AM; O'Donoghue, E; Burke, A; Suliman, AW; Salem, M; O'Toole, A; Ibrahim Yearoo, A; Javid, S; Ullah, I; Bolger, K; Dunican, E; McCullagh, B; Curtin, D; Lonergan, MT; Dillon, L; Murphy, AW; Gaine, S . a national house staff audit of medical prophylaxis in medical patients for the PREVENTion of Venous ThromboEmbolism (PREVENT-VTE). IMJ 2013;106(10):302-305)11.

The ENDORSE study, which included a greater number of patients, reported that 51.8% were in the high risk VTE category12(Cohen, AT; Tapson, VF; Bergmann, JF; Goldhaber, SZ; Kakkar, AK; Deslandes, B; Huang, W; Zayaruzny, M; Emery, L; Anderson, FA Jr. Venous Thromboembolism risk and prophylaxis in the acute hostial care setting (ENDORSE study): a multinational cross-sectional study. Lancet 2008; 371-387-94.

Health Research and Information Division (2013). Activity in Acute Public Hospitals in Ireland. AnnualReport 2012. Dublin:ESRI).Thrombosis Ireland 2016)

Ceresetto, J. M. Venous thromboembolism in Latin America: a review and guide to diagnosis and treatment for primary care. Clinics 71, 36-46 (2016).

Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Berggvist D, Brecht JG, Greer IA, Heit JA, Hutchinson JL, Kakkar AK, Mottier D, Oger E, Samama MM,Spannagl M. VTE impact assessment group in Europe, Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost 2007;98:756-64

Albricker ACL, Freire CMV, Santos SND, Alcantara ML, Saleh MH, Cantisano AL, Teodoro JAR, Porto CLL, Amaral SID, Veloso OCG, Petisco ACGP, Barros FS, Barros MVL, Souza AJ, Sobreira ML, Miranda RB, Moraes D, Verrastro CGY, Mançano AD, Lima RSL, Muglia VF, Matushita CS, Lopes RW, Coutinho AMN, Pianta DB, Santos AASMDD, Naves BL, Vieira MLC, Rochitte CE. Joint Guideline on Venous Thromboembolism - 2022. Arq Bras Cardiol. 2022 Apr;118(4):797-857

National Institute for Health and Care Excellence. NICE guidelines: venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. 2018. https://www.nice.org.uk /guidance /ng89 /chapter /Recommendations. Accessed September 5, 2018

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Published

2024-06-30

How to Cite

Ajwad Farogh, Noman Ullah Wazir, Saima Mumtaz, Farzana Salman, Ahsan Arif, & Anam Umair. (2024). VENOUS THROMBOEMBOLISM RISK ASSESSMENT IN HOSPITALISED PATIENTS IN A TERTIARY CARE HOSPITAL IN PAKISTAN. Journal of Ayub Medical College Abbottabad, 36(2), 383–387. https://doi.org/10.55519/JAMC-02-13243

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