ISSN: 1859 - 2872
Implementation of venous thromboembolism prophylaxis in gastrointestinal surgical patients through multidisciplinary collaboration between doctors, clinical pharmacists, and nurses at the Center of Digestive Surgery, Bach Mai Hospital
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Abstract
Objective: Analyzing the results of venous thromboembolism prophylaxis (VTE) in gastrointestinal surgical patients through multidisciplinary collaboration between doctors, clinical pharmacists, and nurses. Subject and method: Medical records of eligible post-operative patients at the Gastrointestinal Surgery Center, Bach Mai Hospital were collected during two phases: Pre-intervention phase (cross-sectional, non-interventional study) and intervention phase (prospective study with multidisciplinary collaboration). Patients from both phases were compared regarding baseline characteristics, VTE prophylaxis, and adverse event (VTE or bleeding). Result: A total of 165 patients in the pre-intervention phase and 262 patients in the intervention phase were enrolled. Through multidisciplinary collaboration, the VTE prophylaxis rate was increased significantly from 40.5% to 55.7% (p=0.011). In non-cancer patients, the prophylaxis rate also increased significantly in moderate-risk group (9.7% to 25.5%, p=0.010) and high-risk group (17.6% to 54.0%, p=0.009). The incidence of VTE remained low in both phases (0.6% versus 0.4%, p=0.136), meanwhile, the bleeding rate was higher in the post-intervention group. Conclusion: Multidisciplinary collaboration significantly improved VTE prophylaxis rates in gastrointestinal surgical patients. This model should be expanded in other surgical units to optimize postoperative outcomes.
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References
2. Bộ Y tế (2023) Quyết định số 3908/QĐ-BYT về việc ban hành tài liệu chuyên môn "Hướng dẫn điều trị dự phòng thuyên tắc huyết khối tĩnh mạch".
3. Gould MK, Garcia DA, Wren SM et al, Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl): 227-277. doi:10.1378/chest.11-2297.
4. Anderson DR, Morgano GP, Bennett C et al (2019) American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients. Blood Adv 3(23):3898-3944. doi:10.1182/bloodadvances.2019000975.
5. Key NS, Khorana AA, Kuderer NM et al (2020) Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer: ASCO Clinical Practice Guideline Update. J Clin Oncol 38(5): 496-520. doi: 10.1200/JCO.19.01461.
6. Phạm Hồng Thắm, Phan Lâm Tuấn Minh (2022) Tình hình dự phòng thuyên tắc huyết khối tĩnh mạch trên bệnh nhân ngoại khoa tại Bệnh Viện Nhân Dân Gia Định. Tạp chí Y học Việt Nam 520, tr. 380-388.
7. Tống Thanh Huyền, Nguyễn Đức Trung (2023) Thực trạng dự phòng thuyên tắc huyết khối tĩnh mạch sau phẫu thuật cắt khối u vùng bụng - chậu trên bệnh nhân ung thư tại Viện Phẫu thuật Tiêu hóa - Bệnh viện Trung ương Quân đội 108. Journal of 108 - Clinical Medicine and Phamarcy.
8. Hội Tim mạch học Việt Nam (2022) Khuyến cáo của Hội Tim mạch học Việt Nam về chẩn đoán, điều trị và dự phòng thuyên tắc huyết khối tĩnh mạch. Hội Tim mạch học Việt Nam 2022.
9. Lương Thanh Lâm, Bùi Thị Hương Thảo, Đỗ Giang Phúc (2023) Dự phòng thuyên tắc huyết khối tĩnh mạch tại Bệnh viện Đại học Y Hà Nội giai đoạn 2021 - 2022. Tạp chí Nghiên cứu Y học 164(3): 135-143.
10. Chandrakumar A, Ajmal KK, Suriyaprakash TNK, Anusree S (2016) Clinical pharmacist assisted thromboprophylactic optimization in general surgical patients. Le Pharmacien Hospitalier et Clinicien. 51(2): 134-140. doi:10.1016/j.phclin.2015.12.002.
11. Kiraci ZK, Yalcin N, Cennet O, Demirkan K, Yorganci K (2023) Education and clinical pharmacist-led management strategies for the risk and prophylaxis of venous thromboembolism in general surgery. Thromb J 21(1): 86. doi:10.1186/s12959-023-00530-2.
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