Adequacy of Venous Thromboembolism Risk Assessment and Prophylaxis After Gastrointestinal Surgery in a Sudanese Teaching Hospital: A Prospective Audit

苏丹某教学医院胃肠手术后静脉血栓栓塞风险评估和预防的充分性:一项前瞻性审计

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Abstract

Background Venous thromboembolism (VTE) is a condition that occurs when a blood clot forms in a vein. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Regular monitoring and risk assessment are crucial for effectively using VTE prevention measures. This study aimed to evaluate the practices related to VTE risk assessment and prophylaxis within our surgical unit in a Sudanese teaching hospital. Methods This study was conducted at Alnao teaching hospital and was comprised of two cycles. It examined adult patients who underwent gastrointestinal operations. Data from medical records including age, sex, type of operation, whether VTE and bleeding risk assessments were performed, whether pharmacological or mechanical prophylaxis was administered, and any contraindications to VTE prophylaxis. The practice of VTE risk assessment and prophylaxis prescription was compared to the National Institute for Health and Care Excellence (NICE) guidelines for VTE risk assessment and prophylaxis. Following cycle one, regular educational sessions were conducted for medical staff, emphasizing the need for improved practices in assessing the risk of VTE and prophylaxis prescription. Results 32 patients in cycle one and 29 patients in cycle two were included. VTE and bleeding risks were assessed in 0/32 (0.00%) of patients in cycle one compared to 29/29 (100%) in cycle two. In cycle one, 0/32 (0.00%) patients were given VTE prophylaxis according to the guidelines. This practice improved to 17/29 (58.6%) in cycle two. Conclusion The audit highlights the role of organized methods and education in improving adherence to VTE prophylaxis guidelines. Targeted interventions like educational sessions and risk assessment tools led to significant practice improvements, particularly in low-resource settings. Continuous auditing and training are essential for maintaining and enhancing compliance with VTE prophylaxis standards.

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