Pharmacotherapy · 2006
Prophylaxis against venous thromboembolism in acutely ill medical patients: an observational study.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Peterman Carla M, Kolansky Daniel M, Spinler Sarah A
Аннотация
STUDY OBJECTIVES: To determine the risk factors for venous thromboembolism (VTE) and the rates of prophylactic measures used in acutely ill medical patients.
DESIGN: Prospective observational study.
SETTING: Academic tertiary care medical center.
PATIENTS: One hundred seventy-nine patients admitted to three general medical units over 30 consecutive days and hospitalized for at least 3 days.
MEASUREMENTS AND MAIN RESULTS: On concurrent review of the patients' medical records, 138 (77.1%) of 179 patients received one or more forms of VTE prophylaxis during their hospital stay. Of 41 (22.9%) patients receiving no VTE prophylaxis, 22 (53.7%) had and 19 (46.3%, or 10.6% of the total population) did not have a documented contraindication to anticoagulation. One hundred ten patients (61.5%) had three or more documented VTE risk factors for VTE. The most common prophylaxis was unfractionated heparin 5000 U injected subcutaneously twice/day. Therapeutic anticoagulation was given to 51 patients (28.5%) at some time during their hospitalization for indications other than VTE treatment. Two developed symptomatic VTE (1.1%) while hospitalized. Four patients (2.2%) receiving anticoagulants had adverse outcomes. One patient had minor bleeding, and one developed heparin-induced thrombocytopenia without thrombosis.
CONCLUSION: Rates of VTE prophylaxis were higher than previously reported rates, although no formalized guidelines, standardized order sets, alerting programs, training, or risk-stratification tools were used during the study period. Rates of adverse events were low.
DESIGN: Prospective observational study.
SETTING: Academic tertiary care medical center.
PATIENTS: One hundred seventy-nine patients admitted to three general medical units over 30 consecutive days and hospitalized for at least 3 days.
MEASUREMENTS AND MAIN RESULTS: On concurrent review of the patients' medical records, 138 (77.1%) of 179 patients received one or more forms of VTE prophylaxis during their hospital stay. Of 41 (22.9%) patients receiving no VTE prophylaxis, 22 (53.7%) had and 19 (46.3%, or 10.6% of the total population) did not have a documented contraindication to anticoagulation. One hundred ten patients (61.5%) had three or more documented VTE risk factors for VTE. The most common prophylaxis was unfractionated heparin 5000 U injected subcutaneously twice/day. Therapeutic anticoagulation was given to 51 patients (28.5%) at some time during their hospitalization for indications other than VTE treatment. Two developed symptomatic VTE (1.1%) while hospitalized. Four patients (2.2%) receiving anticoagulants had adverse outcomes. One patient had minor bleeding, and one developed heparin-induced thrombocytopenia without thrombosis.
CONCLUSION: Rates of VTE prophylaxis were higher than previously reported rates, although no formalized guidelines, standardized order sets, alerting programs, training, or risk-stratification tools were used during the study period. Rates of adverse events were low.
Предметные рубрики MeSH
Academic Medical CentersAcute DiseaseAdultAgedAged, 80 and overAnticoagulantsArrhythmias, CardiacAsthmaDrug Administration ScheduleFemaleHeart FailureHeparinHumansMaleMiddle AgedPennsylvaniaPractice Guidelines as TopicProspective StudiesPulmonary Disease, Chronic ObstructiveRisk FactorsStockings, CompressionThromboembolismVenous Thrombosis