The use of thromboprophylaxis on in patients at the Clínica del Country

An analysis of compliance with the institutional guideline

Abstract

Venous thromboembolism (VTE) is a frequent disease among hospitalized patients, potentially fatal, which causes significant morbidity among survivors, and is widely preventable. Despite this, VTE prophylaxis is commonly underused.

Objective: to establish the physicians"(TM) adherence to the Venous thromboembolism prevention guidelines for hospitalized patients, at Clinica del Country in Bogotá, Colombia.

Results: we analyzed 262 inpatient charts between July 1st and 31st 2008 and we excluded 22. Among 240 hospitalized patients, 158 (65.8%) required VTE prophylaxis according to the institutional guidelines. Only 83 of them (52.5%) received the intervention. This percentage was higher in medical patients (60%) than in surgical cases (41.3%). This prescription was totally correct in terms of type of recommendation, duration and dose only in 34.5% of the patients. In a group of patients with significant VTE risk and absence of prophylaxis or prescription error, the main reasons were oversight (35%), dosing errors or inappropriate length of treatment (27%), and risk underestimation (13%).

Conclusions: the VTE prophylaxis rate in our institution is similar to that of our country and even to international ones. However it is far from what is convenient for our patients. It is necessary to implement measures that really modify the physicians"(TM) behavior to improve the prevention of VTE among hospitalized patients