Use of heparin for the prevention of venous thromboembolism

Abstract

The value of heparin in the prevention of venous thromboembolism has been shown effective and safe by controlled studies. However, how these studies have influenced physicians' decisions in thrombo‐prophylaxis is not known. With the aim of evaluating the frequency and the appropriateness of prophylaxis for venous thromboembolism in our centre, we performed a cross‐sectional study on a specific day. Among 667 patients who were admitted to hospital on this day, 134 (20 per cent) were receiving heparin. This had been prescribed for the prophylaxis of venous thromboembolism to 82 (12 per cent) patients. Immobilization was the risk factor most strongly associated with prophylaxis. Prophylaxis with heparin was only used in 79 out of 444 high‐risk patients (21.6 per cent). One hundred and eighty‐three patients had been subject to major surgery and heparin was being given only to 34 of them (18.6 per cent). A wide variability in the use of prophylaxis, depending on the hospital ward, was also recorded. We conclude that prophylaxis with heparin is underused in our milieu.

Use of venous thromboprophylaxis and adherence to guideline recommendations: a cross-sectional study

“…We had previously documented an underuse of VTE prophylaxis before the institutional guideline was available [16,19] and an increased use of VTE prophylaxis two years after its implementation (unpublished data). A trend towards greater use of VTE prophylaxis is apparent during a ten-year period (table 5).…”

“…In spite of this scientific evidence, several studies have shown underuse of prophylaxis [15-18]. Previous studies carried out in our hospital on the use of deep vein thrombosis prophylaxis showed poor adherence to accepted recommendations [16,19]. The main problem was low use of prophylaxis in moderate/high risk patients.…”