Cross-sectional study of adherence to venous thromboembolism prophylaxis guidelines in hospitalized patients. The Trombo-Brit study

Abstract

BackgroundDVT is the main cause of death in hospitalized patients and thromboprophylaxis is the only way to prevent these deaths. International recommendations suggested that active monitoring of DVT/PE prophylaxis can improve the efficacy in Hospitals.MethodsWe performed a cohort study in three consecutives periods to evaluate DVT prophylaxis in 388 adults hospitalized in a General Hospital.Results85% of the population had high risk factors for DVT. Thromboprophylaxis was in accordance with local and International guidelines (ACCP 2008) in 72.7% and 86% of the patients respectively. No significant difference could be founded between clinical and surgical patients. One every 10 patients received higher prophylaxis than suggested by guidelines and two out of ten received deficient or no prophylaxis. The worst 2 groups of patients were those with moderate/low risk of DVT and the group with a contraindication to pharmacologic prophylaxis. We observed a progressive improvement of the DVT prophylaxis in the 3 periods of evaluation.ConclusionsAlthough the rate of recommended thromboprophylaxis is higher than many other reports in the region we still have some areas where we need to improve. Regular audits like these are very helpful to find out what specific areas of the hospital needs some careful attention in order to have a better quality of assistance.

Risk of venous thromboembolic disease and adequacy of prophylaxis in hospitalized patients in Argentina: a multicentric cross-sectional study

“…Regarding the two previous studies performed in Argentina [13,14], adherence rates of ATP in this study were lower. Previous studies were conducted in a single center, with fewer beds, facilitating a tighter control of the prescriptions.…”

Distinct predictors of pre‐ versus post‐discharge venous thromboembolism after hepatectomy: analysis of 7621 NSQIP patients

“…Based on historical practice patterns and published cross-sectional studies, it would be reasonable to assume that the routine and timely use of postoperative VTE chemoprophylaxis was not universal and that the use of extended chemoprophylaxis was infrequent. [21][22][23] The true, or 'natural' , event rates for early and late VTE may not be exactly as reported by NSQIP. However, the scale of the national cohort and the standardization of the definitions used allowed for a detailed analysis of these thrombotic events, which may occur too rarely to support evaluation with adequate power in single-institution databases.…”

“…Thus, it is imperative that this study be interpreted according to the disclosure that event rates and subsequent analyses are based on current national practice patterns, the granular details of which are not measured by NSQIP. Based on historical practice patterns and published cross‐sectional studies, it would be reasonable to assume that the routine and timely use of postoperative VTE chemoprophylaxis was not universal and that the use of extended chemoprophylaxis was infrequent . The true, or ‘natural’, event rates for early and late VTE may not be exactly as reported by NSQIP.…”

Essentials zu der S3-Leitlinie zur Prophylaxe venöser Thromboembolien

“…Die Einführung konsistenter Leitlinien und standardisierter Strategien zur Risikoabschätzung im Rahmen einer Thromboseprophylaxe sollen zu einer gesteigerten Patientensicherheit führen [8,9]. Die aktuelle S3-Leitlinie zur Prophylaxe der venösen Thromboembolien (VTE) ist eine komplett überarbeitete Version der ersten Auflage (2009) und steht seit Oktober 2015 online zur Verfügung.…”