Low awareness of venous thromboembolism among neurosurgical hospitalized patients: a cross-sectional study

Abstract

Background Venous thromboembolism (VTE) including Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE), is a serious cause of patient morbidity and mortality in hospitals. Neurosurgical hospitalized patients have higher rates of immobility and bed rest, thus increasing their risk of developing VTE. This highlights the need for their thromboprophylaxis regimens. Patients’ awareness of VTE is essential for promoting strategies such as early ambulation and encouraging self-assessment and self-reporting of VTE signs and symptoms. This study evaluated neurosurgical hospitalized patients’ awareness of VTE and explored the influencing factors to provide a theoretical basis for nursing intervention. Methods We selected one tertiary level hospital in Hunan Province and randomly sampled eligible patients from each five neurosurgical units. We conducted a cross-sectional survey of the hospitalized patients of neurosurgery using the self-designed and validated VTE knowledge questionnaire, and the influencing factors were analyzed using SPSS 26.0. Results A total of 386 neurosurgical hospitalized patients completed the survey. The score of VTE knowledge in neurosurgical hospitalized patients was 13.22 (SD = 11.52). 36.0% and 21.2% of participants reported they had heard of DVT and PE, respectively. 38.9% of participants were unable to correctly identify any symptoms of VTE. The most frequently identified risk factor was ‘immobility or bed rest for more than three days’ (50.0% of participants), and 38.1% of patients agreed that PE could cause death. 29.5% of participants were unable to identify any prophylactic measures of VTE. The results of Negative Binomial Regression showed that the influencing factors of VTE knowledge in neurosurgical hospitalized patients were education level (P < 0.004) and sources of information related to VTE, including nurses (95% CI = 2.201–4.374, P < 0.001), and family member/friend (95% CI = 2.038–4.331, P < 0.001), Internet/TV (95% CI = 1.382–2.834, P < 0.001). Other sources included patient /pamphlet/poster /professional books (95% CI = 1.492–3.350, P < 0.001). Conclusions This study demonstrates the lack of awareness of VTE among neurosurgical hospitalized patients. More attention must be paid to carrying out training on VTE knowledge according to different characteristics of neurosurgical hospitalized patients, so as to ensure safe and high-quality patient care.

Profilaxis de enfermedad tromboembólica venosa en pacientes neuroquirúrgicos: A call to action!

“…En concreto, la ETV es una de las mayores comorbilidades asociadas a los pacientes sometidos a una neurocirugía. Así, dentro del grupo de pacientes hospitalizados, éstos tienen uno de los mayores riesgos de ETV 3 . Con frecuencia, las manifestaciones clínicas de ETV en estos pacientes son insidiosas, no fácilmente predecibles y con pocos signos de alarma.…”

“…Con frecuencia, debido al miedo al sangrado en pacientes con cirugía del SNC, la profilaxis se retrasa o no se realiza conllevando un mayor riesgo de ETV, con aumento de la morbilidad y la mortalidad asociadas. 3 La clásica tríada de Virchow, que incluye estasis venoso, alteración de la pared vascular y la presencia de un estado hipercoagulante, subyace en el desarrollo de la ETV en los pacientes neuroquirúrgicos. El estasis venoso se afecta por la anestesia y la parálisis que se producen durante la cirugía y el postoperatorio con la terapia hidroelectrolítica.…”