Adherence to Thromboprophylaxis Guidelines in Acutely ill and Immobilized patients: A Clinical Audit

Background: Thromboprophylaxis is a proven and safe strategy for hospitalized patients. However, many hospitals still don’t use these preventive measures enough, despite their benefits. Objective: To evaluate the risk and adoption of thromboprophylaxis guidelines in acutely ill and immobilized patients in a tertiary care hospital. Method: This prospective observational study was conducted in the medical wards of Hayatabad Medical Complex (HMC), Peshawar from April 2021 to September 2022. A total of 4260 patients were hospitalized in medical wards during the study period. The simple random sampling technique allowed the inclusion of 600 patients with equal representation from all the three medical units of HMC. Results: Among the admitted patients, 336 (56%) were females while 264 (44%) were males. Patients stratified as High Risk were 435 (72%) while the remaining 165 (28%) were in Low-risk group. Total 345 (57.5%) patients received Venous thromboembolism (VTE) prophylaxis with 187 (31.2%) in the High-Risk group while 158 (26.4%) in the low-risk group. Amongst these74 (12.3%) patients received both the modalities Thromboembolic Deterrent (TED) Stockings and anticoagulation therapy while remaining 173 (28.6%) received TED Stockings alone, and 101 (16.7%) received anticoagulation therapy alone. Implementation of VTE prophylaxis is estimated to be 31.2% in high-risk group and 26.4% in low-risk group patients. Conclusion: Present investigation revealed substantial underutilization of venous thromboembolisms prophylaxis to seriously ill medical ward patients and emphasize the urgent requirement for amended implementation of current guidelines in hospitals, so as to ensure optimal venous thromboprophylaxis practices and prevent avoidable cases of venous thromboembolism.