Adequacy of venous thromboembolism risk stratification and prophylaxis in a tertiary university hospital.

IF 0.8 Q4 PERIPHERAL VASCULAR DISEASE Jornal Vascular Brasileiro Pub Date : 2023-07-17 eCollection Date: 2023-01-01 DOI:10.1590/1677-5449.202300071
Edvaldo Luiz Ramalli, Marcelo Bellini Dalio, Maurício Serra Ribeiro, Edwaldo Edner Joviliano
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Abstract

Background: Venous thromboembolism is the third most common cardiovascular disease and the main cause of preventable death in hospitalized patients. Prophylaxis is still underused, despite well-established guidelines in the literature. Studies show a worldwide prophylaxis adequacy rate close to 50%.

Objectives: To assess the adequacy of risk stratification and prophylactic measures for venous thromboembolism in a tertiary university hospital.

Methods: A cross-sectional observational study was carried out, collecting data from medical records. Adult patients hospitalized by different specialties were enrolled and divided into surgical and clinical groups. The risk stratification of venous thromboembolism performed by the attending physicians was compared with stratification based on recent guidelines performed by the research physicians. Prophylaxis measures prescribed by the attending physicians were compared with guideline recommendations, thus obtaining the prophylaxis adequacy rate.

Results: 400 patients were analyzed, 169 (42.3%) surgical and 231 (57.7%) clinical. The overall stratification adequacy rate was 50.8%. Adequacy rates were 39.1% and 59.3% in the surgical and clinical groups respectively (P < 0.0001). The overall prophylaxis adequacy rate was 71.5%, with 78.1% in the surgical group and 66.7% in the clinical group (P=0.0137).

Conclusions: Risk stratification adequacy is low, demonstrating a low awareness among prescribing physicians of the need for adequate stratification for prescription of prophylaxis. However, the prophylaxis prescription adequacy rates are higher than those in global data.

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三级大学医院静脉血栓栓塞风险分层和预防的充分性。
背景:静脉血栓栓塞症是第三常见的心血管疾病,也是住院患者可预防死亡的主要原因。尽管文献中有完善的指导方针,但预防仍然没有得到充分利用。研究表明,全世界的预防充分率接近50%。目的:评估三级大学医院静脉血栓栓塞症风险分层和预防措施的充分性。方法:采用横断面观察性研究,收集病历资料。按不同专业住院的成年患者被纳入并分为手术组和临床组。将主治医师进行的静脉血栓栓塞症的风险分层与研究医师根据最新指南进行的分层进行比较。将主治医师规定的预防措施与指南建议进行比较,从而获得预防充分率。结果:分析了400例患者,其中外科169例(42.3%),临床231例(57.7%)。总体分层充分率为50.8%。手术组和临床组的充分率分别为39.1%和59.3%(P<0.0001)。总体预防充分率为71.5%,其中手术组为78.1%,临床组为66.7%(P=0.0137)。结论:风险分层充分率较低,这表明开处方的医生对预防处方进行充分分层的必要性的认识较低。然而,预防性处方的充足率高于全球数据。
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来源期刊
Jornal Vascular Brasileiro
Jornal Vascular Brasileiro Medicine-Cardiology and Cardiovascular Medicine
CiteScore
1.20
自引率
0.00%
发文量
57
审稿时长
20 weeks
期刊介绍: The Jornal Vascular Brasileiro is editated and published quaterly to select and disseminate high-quality scientific contents concerning original research, novel surgical and diagnostic techniques, and clinical observations in the field of vascular surgery, angiology, and endovascular surgery. Its abbreviated title is J. Vasc. Bras., which should be used in bibliographies, footnotes and bibliographical references and strips.
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