Introduction: Patients undergoing orthopedic surgery are at high risk of venous thromboembolism (VTE), but the prophylactic practices are suboptimal. We aim to investigate the risk of VTE, the appropriateness of VTE prophylaxis and its associated factors in patients undergoing lower limb orthopedic surgery.

Method: A cross-sectional study was conducted at Gia Dinh People’s Hospital. Data was collected from medical records of patients aged ≥18 years undergoing lower limb orthopedic surgery between March 1st 2020 and June 30th 2020. VTE risk was stratified using the Caprini Risk Assessment Model, contraindications to anticoagulation and the appropriateness of thromboprophylaxis were evaluated according to current guidelines. Multivariate logistic regression analysis was used to determine factors associated with the appropriateness of VTE prophylaxis.

Results: A total of 217 patients was included (median age 54, 57.6% male). There were 80.2% of patients at risk of VTE. Overall rate of appropriate VTE prophylaxis was 35.0%. Patients with age ≥41, BMI >25 kg/m2, surgical duration >45 minutes, plaster cast or screw splint were less likely to receive appropriate VTE prophylaxis; patients with hospital stay >4 days after surgery got more chances to have proper VTE prophylaxis (p <0.05).

Conclusions: The majority of patients undergoing lower limb orthopedic surgery were at risk of VTE, but the rate of appropriate VTE prophylaxis was low. Factors associated with the appropriateness of VTE prophylaxis were age, BMI, surgical duration, plaster cast or screw splint, and length of hospital stay after surgery. Interventions are needed to improve the appropriateness of VTE prophylaxis. 

Introduction: Venous thromboembolism (VTE), a highly prevalent complication in cancer patients, causes prolonged hospitalization and mortality. This study aimed to investigate the characteristics of VTE in older patients with cancer.

Methods: This was a retrospective study. Data were extracted from electronic medical records at the Geriatrics-Palliative Care Department of University Medical Center Ho Chi Minh City. Inclusion criteria included: aged ≥ 60 years, confirmed or newly diagnosed with cancer, and new VTE diagnosis. Exclusion criteria included lacking any information on demographics, laboratories, or treatments. Pulmonary embolism (PE) was confirmed using chest computerized tomography scans, while deep vein thrombosis (DVT), and other types of venous thrombosis were confirmed based on a doppler or abdominal ultrasound. Data were analyzed using Stata 15.0, with p <0.05 signifying statistical significance.

Results: Data of 151 patients were extracted from 1170 medical records (median age: 67, range 60 to 89 years). The three most frequent types of VTE were portal vein thrombosis (48.3%), PE (30.5%), and DVT (29.1%). Stage IV cancer was found in 74.2% of VTE patients. Leg pain was presented in 59.1% of the patients with DVT, and dyspnea was confirmed in 80.4% of the patients with PE. Anticoagulant therapy was the most common treatment for VTE (33.8%) and no major bleeding was recorded.

Conclusions: VTE was highly common among older patients with advanced cancer. Leg pain was an indicator of DVT and dyspnea was a warning sign of PE in older patients with cancer. No major bleeding was recorded in those receiving anticoagulants.