Original clinical investigation
Venous thromboembolism risk and prophylaxis in the acute hospital care setting: report from the ENDORSE study in Egypt
1 Professor of Medicine Cairo University (Sabbatical), Hematologist, Saskatoon Cancer Centre, Saskatoon, Canada
2 Professor of Vascular Surgery, Ain Shams University, Cairo, Egypt
3 National Cancer Institutes, Cairo, Egypt
4 Professor of Medicine, Cairo University, Cairo, Egypt
5 Prof. of General Surgery, Ahmed Maher Teaching Hospital and Al Salam Hospital, Mohandeseen, Cairo, Egypt
6 Shabrawishy Hospital, Cairo, Egypt
Thrombosis Journal 2012, 10:20 doi:10.1186/1477-9560-10-20
Published: 5 September 2012Abstract
Background
Venous thromboembolism (VTE) is a leading cause of hospital-related deaths worldwide. However, the proportion of patients at risk of VTE who receive appropriate prophylaxis in Egypt is unknown. The ENDORSE study in Egypt is part of a global initiative to uncover the incidence of high-risk surgical and medical patients and determine what proportion of these patients receive appropriate VTE prophylaxis.
Methods
Ten Egyptian hospitals participated in this observational study, enrolling all surgical and medical patients that met the study criteria. This resulted in a cohort of 1,008 patients in acute care facilities who underwent a retrospective chart review. Each patient’s VTE risk status and the presence or absence of appropriate prophylactic care was assessed according to the American College of Chest Physicians (ACCP) guidelines 2004.
Results
Of the 1,008 patients enrolled, 395 (39.2%) were found to be at high-risk for VTE. Overall, 227 surgical patients were at high-risk, although only 80 (35.2%) received ACCP-recommended prophylaxis. Similarly, 55/268 (32.75%) of high-risk medical patients received appropriate VTE prophylaxis. Low molecular weight heparin was the most commonly used anticoagulant, while mechanical prophylactic use was quite low (1.5%) in high-risk patients.
Conclusions
In Egypt, more than one-third of all patients hospitalized for surgery or acute medical conditions are at high risk for developing VTE. However, only a small fraction of these patients receive appropriate VTE prophylaxis. Corrective measures are necessary for preventing VTE morbidity and mortality in these high risk patients.
