Venous thromboembolism prophylaxis in acutely ill medical patients: definite need for improvement

Détails

ID Serval
serval:BIB_5EC955866BC8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Venous thromboembolism prophylaxis in acutely ill medical patients: definite need for improvement
Périodique
Journal of Internal Medicine
Auteur(s)
Chopard  P., Dorffler-Melly  J., Hess  U., Wuillemin  W. A., Hayoz  D., Gallino  A., Bachli  E. B., Canova  C. R., Isenegger  J., Rubino  R., Bounameaux  H.
ISSN
0954-6820 (Print)
Statut éditorial
Publié
Date de publication
04/2005
Volume
257
Numéro
4
Pages
352-7
Notes
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Apr
Résumé
AIM OF THE STUDY: To examine the frequency and adequacy of thromboprophylaxis in acutely ill medical patients hospitalized in eight Swiss medical hospitals. METHODS: A cross-sectional study of 1372 patients from eight Swiss hospitals was carried out. After exclusion of patients (275) given therapeutic anticoagulation, 1097 patients were audited. The adequacy of thromboprophylaxis was assessed by comparison with predefined explicit criteria. RESULTS: Of 1097 patients, 542 (49.4%) received thromboprophylaxis. According to the explicit criteria, 644 (58.7%) should have been on prophylaxis (P < 0.001, when compared with the rate observed). The rate of prevention differed widely between hospitals (from 29.4 to 88.6%) with no difference between teaching and nonteaching hospitals. According to the explicit criteria, a substantial proportion (44.9%) of the patients who should have been treated were not. Conversely, 41.3% of the patients were unnecessarily treated. CONCLUSIONS: Even though the appropriateness of the explicit criteria used could be challenged, our data suggest that the current practice is associated with important uncertainty leading to both overuse and underuse of thromboprophylaxis in patients hospitalized in medical wards. More efforts are urgently needed to develop new or endorse existing explicit, evidence-based criteria and guidelines for thromboprophylaxis in this population of patients.
Mots-clé
Acute Disease Adult Aged Cross-Sectional Studies Female Guideline Adherence Hospitals/standards Hospitals, Teaching/standards Humans Male Medical Audit Middle Aged Practice Guidelines Professional Practice/standards Pulmonary Embolism/*prevention & control *Quality of Health Care Switzerland Venous Thrombosis/*prevention & control
Pubmed
Web of science
Open Access
Oui
Création de la notice
17/01/2008 17:38
Dernière modification de la notice
20/08/2019 15:16
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