Deep vein thrombosis prophylaxis

Main Article Content

Gloria Alejandra Sandoval-Chagoya
Rafael Laniado-Laborína

Keywords

Venous thrombosis, Embolism

Abstract

Background: despite the proven effectiveness of preventive therapy for deep vein thrombosis, a significant proportion of patients at risk thromboembolism do not receive prophylaxis during hospitalization. Our objective was to determine the adherence to thrombosis prophylaxis guidelines in a general hospital as a quality control strategy.

Methods: a random audit of clinical charts was conducted at the Tijuana General Hospital, Baja California, Mexico, to determine the degree of adherence to deep vein thrombosis prophylaxis guidelines. The instrument used was the Caprini’s checklist for thrombosis risk assessment in adult patients.

Results: the sample included 300 patient charts; 182 (60.7 %) were surgical patients and 118 were medical patients. Forty six patients (15.3 %) received deep vein thrombosis pharmacologic prophylaxis; 27.1 % of medical patients received deep vein thrombosis prophylaxis versus 8.3 % of surgical patients (p < 0.0001).

Conclusions: our results show that adherence to DVT prophylaxis at our hospital is extremely low. Only 15.3 % of our patients at risk received treatment, and even patients with very high risk received treatment in less than 25 % of the cases. We have implemented strategies to increase compliance with clinical guidelines.

Abstract 123 | PDF (Spanish) Downloads 55

References

De Bastos MD, Barreto SM, Caiafa JS, Rezende SM. Thromboprophylaxis: medical recommendations and hospital programs. Rev Assoc Med Bras. 2011;57 (1):87-97. Texto libre en http://www.scielo.br/scielo. php?script=sci_arttext&pid=S0104-4230201100 0100022&lng=en&nrm=iso&tlng=en

 

Geerts WH, Heit JA, Clagett GP, Pineo GF, Colwell CW, Anderson FA, et al. Prevention of venous thromboembolism. Chest. 2001;119(Supl 1):132S-75S.

 

Chapman NH, Lazar SP, Fry M, Lassere MN, Chong BH. Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis. BMC Health Serv Res. 2011;11:240. Disponible en http://www.biomedcentral.com/1472-6963/11/240

 

Pérez-García A, Briones-Pérez B. Thromboprophylaxis in post-surgical patients: review of 1,500 cases. Cir Cir. 2004;72(4):287-91.

 

Tapson VF, Decousus H, Pini M, Chong BH, Froehlich JB, Monreal M, et al. Venous thromboembolism prophylaxis in acutely ill hospitalized medical patients: findings from the International Medical Prevention Registry on Venous Thromboembolism. Chest. 2007;132(3):936-45.

 

Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ, Kakkar AK, Deslandes B, et al. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet. 2008;371 (9610):387-94.

 

Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon. 2005;51(2-3):70-8.

 

Martínez-Murillo C, Aguilar-Arteaga MR, Velasco-Ortega E, Alonso-González R, Castellanos-Sinco H, Romo-Jiménez A, et al. Guía de práctica clínica. Diagnóstico y tratamiento de la enfermedad tromboembólica venosa. Rev Med Inst Mex Seguro Soc. 2011;49(9):437-49.

 

Martínez-Zubieta R. Tromboembolismo venoso y profilaxis en enfermedades agudas hospitalarias. Resultados en México de un estudio transversal multicéntrico (ENDORSE II). Cir Cir. 2010;78(4):333-41.

 

Kucher N, Koo S, Quiroz R, Cooper JM, Paterno MD, Soukonnikov B, et al. Electronic alerts to prevent venous thromboembolism among hospitalized patients. N Engl J Med. 2005;352(10):969-77.

 

Huang A, Barber N, Northeast A. Deep vein thrombosis prophylaxis protocol–needs active enforcement. Ann R Coll Surg Engl. 2000;82(1):69-70. Texto libre en http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503451/pdf/annrcse01623-0077.pdf

 

Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MA; American College of Chest Physicians, et al. Prevention of venous thromboembolism. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133(Supl 6):381S-453S.