An Observational Study to Assess Venous Thromboembolism (VTE) Prophylaxis Compliance and Patient Risk Stratification in a Tertiary Care Hospital

Abstract

Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant yet largely preventable cause of morbidity and mortality among hospitalized patients. Despite the availability of evidence-based guidelines from organizations such as the American College of Chest Physicians (ACCP) and the National Institute for Health and Care Excellence (NICE), adherence to recommended prophylactic measures remains inconsistent in many healthcare settings. The present study aimed to assess the level of compliance with VTE prophylaxis guidelines and to examine patient risk stratification in a tertiary care hospital. A retrospective observational cross-sectional study was conducted among hospitalized patients in selected wards of a tertiary care center. Data were collected using a structured case report form and a validated questionnaire through review of electronic health records and consultation with healthcare professionals. A total of 96 patients with documented VTE risk assessments were included for clinical analysis, while 100 survey responses were analyzed for statistical evaluation. Patients were categorized into low-, moderate-, and high-risk groups based on standard risk assessment models. Statistical analysis was performed using IBM SPSS Statistics version 26, employing descriptive statistics, Pearson correlation analysis, chi-square tests, and regression analysis to examine relationships among clinical variables and prophylaxis practices. The findings revealed moderate but inconsistent adherence to VTE prophylaxis guidelines. Among the studied patients, 48% were categorized as high risk, 35% as moderate risk, and 17% as low risk for VTE. Appropriate prophylaxis was administered to 58% of high-risk patients, indicating that 42% remained untreated despite their elevated risk. In the moderate-risk group, 42% received prophylaxis, reflecting partial compliance with guidelines. Conversely, 18% of low-risk patients received unnecessary prophylaxis, suggesting overtreatment. Pharmacological prophylaxis, particularly low-molecular-weight heparin and unfractionated heparin, was commonly used, although mechanical methods were also applied. Dose adherence was inconsistent, with 56% of patients missing at least one prophylactic dose, and only 28% receiving regular monitoring for potential bleeding complications. Correlation analysis indicated weak associations between risk assessment and prophylaxis prescription, whereas discussions of clinical guidelines among healthcare providers demonstrated a modest positive relationship with dose adherence.