Prevention of venous thromboembolism through the implementation of a risk assessment tool: a comparative study in medical and surgical patients

Park, Min Y; Fletcher, J.; Hoffmann, Carmen Anita; Lance, Alice; Gavegan, Fiona; Hitos, Kerry

doi:10.23736/s0392-9590.18.03969-x

Cited by 9 publications

(1 citation statement)

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“…This study found a low rate of VTE RAT completion of 49.0% overall. Park et al 20 in 2018 found that chemical and mechanical prophylaxis prescribing rates increased post-implementation of a standardised RAT, and rates of both fatal and non-fatal PE decreased across a general hospital population at a similar Australian centre. In this study, VTE RAT completion rates improved, averaging 62.4% from 2017 onwards compared to an average of 14.9% prior to 2017.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism prophylaxis practices and outcomes at an Australian level-one trauma service

Hamilton

Cocco

Shakerian

et al. 2021

Trauma

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Background Venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major cause of potentially preventable morbidity and mortality amongst trauma patients. Venous thromboembolism prevalence varies from 1 to 58%, and traditionally, compliance with prophylaxis protocols is low in major trauma cohorts. This study aimed to describe VTE prevalence, prophylaxis practices and outcomes amongst VTE cases at an Australian level-one trauma centre. Methods A retrospective review of all VTE cases occurring in acute, major trauma admissions between 1 January 2010 and 30 June 2019 was conducted using prospectively collected registry data. Data regarding demographics, time to diagnosis, VTE prophylaxis, VTE risk assessment tool (RAT) usage and all-cause mortality were collected. Chemoprophylaxis was considered adequate if administered for 48 h prior to diagnosis. VTE cases diagnosed within 48 h of admission were excluded from prophylaxis compliance analysis. A subgroup analysis of patients with intracranial haemorrhage (ICH) was also completed. Results During the study period, 238 VTE events occurred in 237 patients from 7482 major trauma admissions, giving a VTE prevalence of 3.18%. The all-cause mortality rate was 8.0%. VTE chemoprophylaxis was administered for 109 of 211 eligible patients (51.7%). Of the remaining 102 VTE cases, 75 (73.5%) did not receive prophylaxis due to a documented contraindication, while 27 (26.5%) did not receive prophylaxis with no contraindication recorded. The VTE RAT was completed in 49.0% of cases. Conclusion Venous thromboembolism prevalence at our institution was consistent with published figures for comparable institutions. A review of compliance with prophylaxis protocols showed several potential areas for improvement.

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Section: Discussionmentioning

confidence: 99%