2007, Number 4
Are there hospitals or patients sick? Part II
Prophylaxis of the venous thromboembolic disease in Medica Sur
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ABSTRACTIntroduction: Venous thromboembolic disease (VTD) and pulmonary embolism (PE) have a high prevalence in hospitalized patients and are associated with increased morbidity and mortality. The antithrombotic prophylaxis is a highly effective and low cost measure in order to decrease the incidence of these complications. Objective: To evaluate the risk of VTD and prophylactic anticoagulation practice in inpatients in the Médica Sur Clinic Foundation. Patients and methods: An epidemiological survey in one day was done, an evaluation of thromboembolism risk was calculated and the antithrombotic measures were evaluated. The survey was made following the conference of consensus of VTD of the American Collage of the Chest physician (ACCP) lineaments. The patients were classified in low, moderate, high, and very high risk for VTD accord to score obtained. In a whole group and in every group the prophylactic anticoagulation practice was evaluated which was divided into adequate or inadequate accord to conference of consensus recommendations. Results: All of hospitalized patients revised had some degree of risk for VTD. 53% patients have very high risk. Only 22.2% the patients of the whole group had adequate prophylactic anticoagulation measures, of the remaining 78% patients, 58.8% had inadequate measures and 18.8% did not have any prophylactic measure. Only 26.4% with very high risk and 9.0% with high risk patients had adequate thromboprophylactic measures. Low molecular weight heparin and compressive pneumatic devices are sub-utilized. Graduating compressive stockings were the more used measure. Any revised file had VTD risk evaluation. Conclusion: Results of this study demonstrate that VTD risk is elevated in hospitalized patients and the recommended measures for thromboprophylaxis accord to level of risk do not follow them. We recommend starting an intensive and proactive educational campaign in the medical and nurse group in order to create conscience about the problem and to implement a strategy with the objective of our institution be free of VTD.
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