Abstract
PREDICTIVE VALUE OF VENOUS THROMBOEMBOLISM RISK ASSESSMENT SCORING TOOLS AMONG SURGICAL PATIENTS

Olufemi-Aworinde K. J.*, Aworinde O. O., Olutogun T. A., Ogunlaja A. O., Joel-Medewase V. I., Akinola N. O.

ABSTRACT

Venous thromboembolism represents a spectrum of conditions that includes deep venous thrombosis (DVT) and pulmonary embolism (PE). It is affects hospitalized and non-hospitalized patients, recurs frequently, is often overlooked, and results in long-term complications including chronic thromboembolic pulmonary hypertension (CTPH) and the post-thrombotic syndrome (PTS). This prospective study aimed at assessing the total risk score of VTE among surgical patients from the departments of General Surgery, Orthopaedics, Obstetrics and Gynaecology before a major operation using three tools- Venous thromboembolism Risk Factor Assessment by Caprini et al (tool 1), Revised Geneva Score for pulmonary embolism (tool 2) and Pretest probability of Deep Venous Thrombosis by Wells (tool 3) thus comparing their predictive value of VTE. Nine hundred and twenty patients were recruited, forty died within 48hours, forty died during follow up and twenty were lost to follow up. Data from 820 patients (250 from General Surgery, 300 from Orthopaedics; and 270 from O&G) were analysed and assessed for the risk of VTE. The administration of prophylactic anticoagulant and the modality chosen by the managing team was documented. The mean age of the patients were 44.5±15.0 years with 72% of the patients being female. Tool 1 assessed the half of the patients 410(50%) to have moderate risk of developing VTE while tool 2 and tool 3 assessed 65.9% and 92.7%to have low probability of VTE respectively. 100 (12%) of the patients studied had prophylactic anticoagulant. It was observed that the use of prophylaxis was highest in the group with the highest risk for VTE irrespective of the tool used. None of the 820 patients developed clinically overt VTE, however, the causes of death of the 100 patients excluded from analysis could not be investigated to rule out VTE. It was concluded that that none of the three tools used could be convincingly declared better than the others because no patient developed symptomatic VTE during the study period and cause of death was unknown among the patients who died.

Keywords: Deep, venous, thromboembolism, predictive, tool, embolism.


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