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Journal of Thrombosis and Thrombolysis

, Volume 46, Issue 1, pp 113–119 | Cite as

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

  • Z. Tazi Mezalek
  • C. Nejjari
  • L. Essadouni
  • M. Samkaoui
  • K. Serraj
  • W. Ammouri
  • N. Kanjaa
  • Z. Belkhadir
  • B. Housni
  • M. Awab
  • M. Faroudy
  • W. Bono
  • S. Kabbaj
  • M. Akkaoui
  • M. Barakat
  • R. Rifai
  • H. Charaf
  • A. Aziz
  • Y. Elachhab
  • A. Azzouzi
Article
  • 64 Downloads

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.

Keywords

Thromboprophylaxis Venous thrombosis Hospitalized patients Risk assessment 

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

Notes

Acknowledgements

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

Compliance with ethical standards

Conflict of interest

All authors declare no conflicts of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Z. Tazi Mezalek
    • 1
    • 2
  • C. Nejjari
    • 3
  • L. Essadouni
    • 4
  • M. Samkaoui
    • 5
  • K. Serraj
    • 6
  • W. Ammouri
    • 1
    • 2
  • N. Kanjaa
    • 7
  • Z. Belkhadir
    • 8
  • B. Housni
    • 9
  • M. Awab
    • 10
  • M. Faroudy
    • 11
  • W. Bono
    • 12
  • S. Kabbaj
    • 13
  • M. Akkaoui
    • 14
  • M. Barakat
    • 15
  • R. Rifai
    • 16
  • H. Charaf
    • 17
  • A. Aziz
    • 18
  • Y. Elachhab
    • 3
  • A. Azzouzi
    • 10
  1. 1.Department of Internal Medicine/HematologyIbn Sina University HospitalRabatMorocco
  2. 2.Faculty of Medicine and PharmacyMohammed V UniversityRabatMorocco
  3. 3.Laboratory of EpidemiologyClinical Research and Community Health Faculty of Medicine and PharmacyFezMorocco
  4. 4.Internal Medicine Department, Faculty of Medicine and Pharmacy, Mohammed VI University HospitalCadi Ayyad UniversityMarrakechMorocco
  5. 5.Department of Anesthesia, Emergency and Intensive Care Medicine, Faculty of Medicine and Pharmacy, Mohammed VI HospitalCadi Ayyad UniversityMarrakechMorocco
  6. 6.Internal Medicine Department, Faculty of Medicine and Pharmacy, Mohammed VI University HospitalUniversity Mohammed VIOujdaMorocco
  7. 7.Department of Anesthesia Reanimation, Faculty of Medicine and PharmacyHassan II University HospitalFezMorocco
  8. 8.Pole of Anesthesia and Intensive Care, Palliative Care UnitNational Institute of OncologyRabatMorocco
  9. 9.Anesthesia Reanimation DepartmentMohammed VI University HospitalOujdaMorocco
  10. 10.Anesthesia Reanimation DepartmentIbn Sina University HospitalRabatMorocco
  11. 11.Anesthesia Reanimation- Trauma UnitIbn Sina University HospitalRabatMorocco
  12. 12.Internal Medicine DepartmentHassan II University HospitalFezMorocco
  13. 13.Anesthesia Reanimation DepartmentSpecialty HospitalRabatMorocco
  14. 14.Anesthesia ReanimationMohammed V HospitalMeknesMorocco
  15. 15.Anesthesia ReanimationMohammed V HospitalTangierMorocco
  16. 16.Traumatology OrthopedicsMohammed V HospitalMeknesMorocco
  17. 17.Anesthesia ReanimationMohammed V HospitalCasablancaMorocco
  18. 18.Traumatology OrthopedicsMohammed V HospitalCasablancaMorocco

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