Nghiên cứu thực trạng sử dụng thuốc dự phòng thuyên tắc huyết khối tĩnh mạch trên bệnh nhân phẫu thuật chỉnh hình lớn

Abstract

Objective: To describe the usage of anticoagulation for venous thromboembolism (VTE) prophylaxis and to evaluate the appropriateness to ACCP 2012 guidelines and licensed product information in patients undergoing major orthopedic surgeries. Subject and method: We recruited patients (≥ 18 years of age) who underwent total hip arthroplasty (THA), total knee arthroplasty (TKA), or hip fracture surgery (HFS) at 108 Military Central Hospital. Result: Between January 2021 and December 2021, 317 eligible patients were included. VTE prophylaxis was prescribed to 97.2% of patients during hospitalization: 46.4% both pharmacological and mechanical tools and 50.8% only pharmacological; 96.2% of patients had appropriate type of VTE prophylaxis. Most patients receiving pharmacological prophylaxis were treated with dabigatran and 73.4% were prescribed ACCP-adherent VTE pharmacological prophylaxis agents. The dose regimen and dosing time were appropriate at 92% and 80.8% of patients, respectively. Patients receiving < 10 days of pharmacological prophylaxis was 1.4%. The proportion of patients with appropriate pharmacological prophylaxis was 51.7% and the main reason for non-adherence to guideline was inappropriate pharmacological agents in HFS group. Conclusion: A gap between clinical practice and guideline recommendations was observed.