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. 2024 Nov 9;16(11):e73316.
doi: 10.7759/cureus.73316. eCollection 2024 Nov.

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

Muaz Hassan  1 , Rami A Adam  2 , Mosab Hussen Mostafa Adam  3 , Rawan Mairghani  4 , Almegdad S Ahmed  5 , Hadeel Abdelseid  6 , Alaa Abdalla  7 , Fatima Mohamedahmed Babiker Mohamed  8 , Ghofran B Yousif  9 , Mohamed A Adam  10 , Hussein A Embarek  11 , Omer H Salim  12
Affiliations

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

Muaz Hassan et al. Cureus. .

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.

Keywords: audit; gastrointestinal surgery; low molecular weight heparin; mechanical prophylaxis; post-operative; venous thromboembolism (vte).

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Alnao University Hospital Research Ethics Committee (AUH-REC) issued approval AUH0710202SI. On behalf of the ethics committee, the following topic was examined and approved for ethical clearance: Adequacy of Venous Thromboembolism Risk Assessment and Prophylaxis After Gastrointestinal Surgery in a Sudanese Teaching Hospital: A Prospective Audit. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Duration of pharmacological prophylaxis in the two cycles:
Number of patients who received pharmacological prophylaxis is 32 in cycle one and 16 in cycle two.
See this image and copyright information in PMC

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