Per citar aquest document: http://ddd.uab.cat/record/113598
Use of venous thromboprophylaxis and adherence to guideline recommendations : a cross-sectional study
Vallano Ferraz, Antonio (Universitat Autònoma de Barcelona. Departament de Farmacologia, Terapèutica i Toxicologia)
Arnau de Bolós, José Mª (Universitat Autònoma de Barcelona)
Permanyer i Miralda, Gaietà (Vall d'Hebron Hospitals)
Pérez Bartolí, Jaume (Vall d'Hebron Hospitals)

Data: 2004
Resum: Background: Consensus Conferences and Guidelines for deep vein thrombosis prophylaxis have been published, which recommend the use of prophylactic heparins in patients with risk of venous thromboembolism (VTE). The aim of this study was the assessment of the prophylaxis of VTE and the adherence to accepted guideline recommendations throughout the hospital. Methods: A cross-sectional study was carried out in a teaching hospital after guidelines were implemented. Patients' risk factors of deep vein thrombosis, risk categories of patients, and prophylaxis used in different wards were recorded. Appropriate adherence to the guidelines was analysed. Results: Of 397 patients, prophylaxis was used in 231 patients (58%), and low-molecular-weight heparins (LMWH) were used in 224 of them (97%). Patients with prophylaxis had a higher mean number of risk factors (SD) than those without prophylaxis [3. 1 (1. 4) vs 1. 9 (1. 4); p < 0. 05)]. Prophylaxis was used in 72% and 90% of moderate and high-risk patients respectively. Appropriate adherence to all guideline recommendations was observed in 42% of patients. Adherence to guidelines was high as regards the use of prophylaxis according to patients' risk factors (78%) and the use of appropriate types of prophylaxis (99%), but was low regarding appropriate heparin dosage (47%) and preoperative dosage (37%). Appropriate prophylaxis use was higher in critical care and surgical wards than in medical wards. Conclusion: Prophylaxis of VTE is generally used in risk patients, but appropriate adherence to guidelines is less frequent and variable among different wards. Continuing medical education, discussion and dissemination of guidelines, and regular clinical audit are necessary to improve prophylaxis of VTE in clinical practice.
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Llengua: Anglès
Document: article ; publishedVersion
Matèria: Embolism ; Thrombosis ; Venous Thrombosis ; Preventive Medicine ; Practice Guidelines ; Heparin ; Low-Molecular-Weight
Publicat a: Thrombosis journal, Vol. 2, N. 3 (April 2004) , p. 1-7, ISSN 1477-9560

DOI: 10.1186/1477-9560-2-3


7 p, 266.5 KB

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