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Evaluation and management of thromboprophylaxis in Moroccan hospitals at national level: the Avail-MoNa study

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Abstract

Venous thromboembolism (VTE) is a common clinical problem that is associated with substantial morbidity and mortality. The aim of this study was to describe the clinical practices in VTE prophylaxis in university and peripheral hospitals in Morocco. This is a national, cross-sectional, multicenter, observational study assessing the management of the VTE risk in selected Moroccan hospitals (four university and three peripheral). The thromboembolic risk of the selected patients was assessed according to the American College of Chest Physicians (ACCP) guidelines (2008). We hypothesized that interventions for VTE guideline implementation in those hospitals may improve prophylaxis use for hospitalized patients. A total of 1318 patients were analyzed: 467 (35.5%) medical and 851 (64.5%) surgical. The mean age of patients was 52.6 ± 16.5 years, and 52.7% were female. A total of 51.1% patients were considered to be at risk of VTE according to ACCP guidelines and were eligible for thromboprophylaxis (TP). Medical patients were more likely to present risk factors than surgical patients (53.6 vs. 50.7%, respectively). TP was prescribed for 53.1% of these patients, 57.4% in at-risk surgical patients and 50.3% in at-risk medical patients. TP was also prescribed for 42.9% of non-at-risk patients. The concordance between the recommended and the prescribed prophylaxis was poor for the total population (kappa = 0.110). TP did not improve sufficiently in our hospitals, even after implementation of the guidelines. New strategies are required to appropriately address TP in hospitalized patients.

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Abbreviations

ACCP:

American College of Chest Physicians

DVT:

Deep vein thrombosis

LMWH:

Low molecular weight heparin

PE:

Pulmonary embolism

RAM:

Risk assessment model

TP:

Thromboprophylaxis

VTE:

Venous thromboembolism

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Acknowledgements

Collection of registry data for this study was sponsored by Sanofi Morocco.

Author information

Authors and Affiliations

  1. Department of Internal Medicine/Hematology, Ibn Sina University Hospital, Rabat, Morocco

    Z. Tazi Mezalek & W. Ammouri

  2. Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

    Z. Tazi Mezalek & W. Ammouri

  3. Laboratory of Epidemiology, Clinical Research and Community Health Faculty of Medicine and Pharmacy, Fez, Morocco

    C. Nejjari & Y. Elachhab

  4. Internal Medicine Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, Cadi Ayyad University, Marrakech, Morocco

    L. Essadouni

  5. Department of Anesthesia, Emergency and Intensive Care Medicine, Faculty of Medicine and Pharmacy, Mohammed VI Hospital, Cadi Ayyad University, Marrakech, Morocco

    M. Samkaoui

  6. Internal Medicine Department, Faculty of Medicine and Pharmacy, Mohammed VI University Hospital, University Mohammed VI, Oujda, Morocco

    K. Serraj

  7. Department of Anesthesia Reanimation, Faculty of Medicine and Pharmacy, Hassan II University Hospital, Fez, Morocco

    N. Kanjaa

  8. Pole of Anesthesia and Intensive Care, Palliative Care Unit, National Institute of Oncology, Rabat, Morocco

    Z. Belkhadir

  9. Anesthesia Reanimation Department, Mohammed VI University Hospital, Oujda, Morocco

    B. Housni

  10. Anesthesia Reanimation Department, Ibn Sina University Hospital, Rabat, Morocco

    M. Awab & A. Azzouzi

  11. Anesthesia Reanimation- Trauma Unit, Ibn Sina University Hospital, Rabat, Morocco

    M. Faroudy

  12. Internal Medicine Department, Hassan II University Hospital, Fez, Morocco

    W. Bono

  13. Anesthesia Reanimation Department, Specialty Hospital, Rabat, Morocco

    S. Kabbaj

  14. Anesthesia Reanimation, Mohammed V Hospital, Meknes, Morocco

    M. Akkaoui

  15. Anesthesia Reanimation, Mohammed V Hospital, Tangier, Morocco

    M. Barakat

  16. Traumatology Orthopedics, Mohammed V Hospital, Meknes, Morocco

    R. Rifai

  17. Anesthesia Reanimation, Mohammed V Hospital, Casablanca, Morocco

    H. Charaf

  18. Traumatology Orthopedics, Mohammed V Hospital, Casablanca, Morocco

    A. Aziz

Authors
  1. Z. Tazi Mezalek
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  2. C. Nejjari
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  3. L. Essadouni
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  4. M. Samkaoui
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  5. K. Serraj
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  6. W. Ammouri
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  7. N. Kanjaa
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  8. Z. Belkhadir
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  9. B. Housni
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  10. M. Awab
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  11. M. Faroudy
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  12. W. Bono
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  13. S. Kabbaj
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  14. M. Akkaoui
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  15. M. Barakat
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  16. R. Rifai
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  17. H. Charaf
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  18. A. Aziz
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  19. Y. Elachhab
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  20. A. Azzouzi
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Corresponding author

Correspondence to Z. Tazi Mezalek.

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Tazi Mezalek, Z., Nejjari, C., Essadouni, L. et al. Evaluation and management of thromboprophylaxis in Moroccan hospitals at national level: the Avail-MoNa study. J Thromb Thrombolysis 46, 113–119 (2018). https://doi.org/10.1007/s11239-018-1657-7

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  • DOI: https://doi.org/10.1007/s11239-018-1657-7

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