Thromboembolic Prophylaxis in Hospitalized Patients with Risk Factors: An underemphasized issue?

Abstract

ÖZETAmaç: Pulmoner emboli (PE), hastanede yatan hastalarda sık görü-len, morbidite ve mortalitesi yüksek bir hastalıktır. PE'lerin önemli bir kısmı alt ekstremite derin venöz sisteminden kaynaklanır ve bu derin ven trombozları (DVT) çoğunlukla asemptomatiktir. DVT ve PE proflaksisi tüm dünyada kabul gören, rutin kullanıma girmiş yöntemler olmasına karşılık risk grubundaki hastalara proflaksi uygulamaları ihmal edilebilmektedir. Çalışmamızı, hastanemizde yatan ve risk faktörü taşıyan hastalarda DVT proflaksisinin hangi sıklıkta uygulandığını araştırmak için planladık. ABST RACTObjective: Pulmonary embolism (PE) is frequent among hospitalized patients, with a high morbidity and mortality rate. Although prophylaxis for PE and deep venous thrombosis (DVT) is accepted worldwide and the procedures are routinely applied, prophylaxis may sometimes be ignored in risk groups. The aim of our study was to evaluate the rates of DVT prophylaxis in risk groups among patients hospitalized in our hospital. Materials and Methods:This cross-sectional study was conducted in January 2008 at Dr. Lutfi Kırdar Kartal Training and Research Hospital. Patients hospitalized in our surgery, orthopedics, intensive care, internal medicine, oncology, plastic surgery, obstetrics and gynecology, pulmonary diseases, neurology, neurosurgery and urology clinics were visited on the same day to evaluate the patients clinically and their medical records. Risk factors for DVT and PE were determined and patients receiving prophylaxis were documented.Results: For the 275 patients, 134 (48.7%) females and 141(51.3%) males, included in the study, the average length of hospital stay was 8.1±10.1 days. The most frequent risk factors were advanced age (52.0%), immobility (38.9%), history of operation (36.4%), malignancy (28.7%) and obesity (21.1%). Among 170 patients who should receive prophylaxis, only 56 (32.9%) were found to receive prophylaxis. The highest rate of prophylaxis was given by the Orthopedics (84.6%) and the Neurology (60.0%) clinics, followed by the Intensive Care Unit (37.5%). During the study period, no patient was found to receive VT prophylaxis in the Gynecology, Oncology, Plastic Surgery and Urology Departments. Conclusion:We have found out that in our hospital, the importance of DVT prophylaxis was not fully practiced. Prophylaxis of high Anah tar kelimeler: Tromboemboli, pulmoner emboli, profilaksi, yatan hasta risk patients for DVT would decrease the incidence of venous thromboembolism and the associated morbidity and mortality. We believe that the appropriate practice of prophylaxis could only be achieved through education.