Source: Annual Congress 2007 - Venous thromboembolism
Disease area: Pulmonary vascular diseases

Abstract

Introduction: 10-20% of hospitalized medical patients develop DVT.In the UK alone, PE following DVT is estimated to causes 25-32,000 hospital deaths per year and is immediate cause in 10%¹. Thromboprophylaxis with low dose heparin is effective in high risk patients not only to prevent fatal PE, but also symptomatic DVT/PE which prolong hospital stay and require further testing increasing cost.Subsequent need for warfain anticoagulation has its attendant risk of bleeding . Purpose of present study was to to determine whether thromboprophylaxis was being used in our institution according to established guidelines².
Method: We reviewed notes and treatment of patients admitted to eight general medical wards over a 2 week period.Cardiology,Hematology/Oncology and Stroke wards were excluded.
Results: 150 patients were reviewed.Age range 31-96 ( Mean=73.9years).Thromboprophylaxis was indicated in 126/150 (84%).21 excluded due to contraindication for aniticoagulation.Of remaining 105 only 37 (35.2%) recieved prophylactic heparin.(See table)
Conclusion:Majority of acutely ill medical patients require thromboprophylaxis.However, despite clear guidelines thromboprophylaxis remains significanly suboptimal.
Referances:
1.2nd report of UK Health Select Committe 23 Feb 2005
2.CHEST 2004; 126:338S–400S.

No.given thromboprophylaxis according to risk factors

RISK FACTOR	No.	No. given prophylaxis
Age moreñ70	82	22(27%)
Acute Heart Failure	12	4(33%)
Active Cancer	9	2(22%)
Severe Infection	7	3 (42%)
Previous DVT/PE	2	1(50%)
History of Malignancy	12	7(58%)
Ischeamic Stroke	5	1(20%)
Immobilityñ48 hours	34	6(17%)
Paraplegia	1	0
Severe Respiratory Disease	17	4 (23%)

Total 181 as some patients had more than one risk factor

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Citations should be made in the following way:
M. Paracha, M. Javed, G. Bhat (Blackpool, Bolton, United Kingdom). Thromboprophylaxis in medical in-patients: are we there yet?. Eur Respir J 2007; 30: Suppl. 51, 629

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