TU5.8 Audit on Adherence to NICE Guidelines for VTE Prophylaxis in Patients Undergoing Surgery for Appendicitis

Abstract

Abstract Background and Aims According to the Nice Guidelines (NG89), for any person (over 16 years) undergoing abdominal surgery, pharmacological VTE prophylaxis must be added for a minimum of 7 days (if the risk of VTE outweighs the risk of bleeding). Also, mechanical VTE prophylaxis must commence on admission. We wanted to audit our adherence to these guidelines in the patients undergoing surgery for appendicitis. Methods A review of the electronic pharmacy records of the patients (over 16 years) who underwent surgery for appendicitis (proven with a CT scan or diagnosed intra-operatively) was performed from October to December 2021. We used the Department of Health VTE risk assessment form, and only the patients whose risk of VTE outweighed the bleeding risk were included. Results Of the 23 patients, 22 (95.6%) underwent laparoscopic appendicectomy and, open appendicectomy was done in 1 (4.4%) patient. 11 (47.8%) patients were females, and 12 (52.2%) were males. The mean age was 38.3 (±16) years, and the mean duration of hospital stay was 2.8 (±1.6) days. VTE risk assessment form was completed only for 12 (52.2%) patients. During the hospital stay, 15 of 23 (65.2%) patients received TEDS, and 18 (78.2%) patients received Enoxaparin. 4 (17.4%) patients did not receive any form of VTE prophylaxis. None of these patients was prescribed seven days of pharmacological prophylaxis. Conclusions VTE prophylaxis prescription in patients with short hospital stays is often missed. We must explore the necessary interventions to ensure that patients are given seven days of VTE prophylaxis and regularly audit this practice.