Abstract
BackgroundVenous thromboembolic disease (VTE) is associated with high morbi-mortality. Adherence rate to the recommendations of antithrombotic prophylaxis guidelines (ATPG) is suboptimal. The aim of this study was to describe the adequacy of antithrombotic prophylaxis (ATP) in hospitalized patients as the initial stage of a program designed to improve physician adherence to –ATP recommendations in Argentina.MethodsThis study was a multicenter, cross-sectional study that included 28 Institutions throughout 5 provinces in Argentina.Results1315 patients were included, 729 (55.4%) were hospitalized for medical (clinical) reasons, and 586 (44.6%) for surgical reasons. Adequate ATP was provided to 66.9% of the patients and was more frequent in surgical (71%) compared to clinical (63.6%) subjects (p < 0.001). Inadequate ATP resulted from underuse in 76.6% of the patients. Among clinical, 203 (16%) had increased bleeding risk and mechanical ATP was used infrequently.ConclusionsThe adequacy of ATP was better in low VTE risk clinical and surgical patients and high VTE risk in orthopedic patients. There was worse adequacy in high risk patients (with active neoplasm) and in those with pharmacological ATP contraindications, in which the use of mechanical methods was scarce. The adequacy of ATP was greater at institutions with < 150 beds compared with larger institutions. This is the first multicentric study reporting ATP in Argentina. Understanding local characteristics of medical performance within our territory is the first step in order to develop measures for improving ATP in our environment.
Highlights
Venous thromboembolic disease (VTE) is associated with high morbi-mortality
This paper describes the adequacy of antithrombotic prophylaxis (ATP) guideline compliance in hospitalized patients as the initial stage of a program designed to improve physician adherence to VTE prophylaxis recommendations
There were 729 (55.4%, CI 95% 53–58) patients hospitalized for clinical reasons and 586 (44.6%, CI 95% 42–47) hospitalized for surgical reasons, of whom, 182 (31.1%) were orthopedic surgeries and 404 (68.9%) were non orthopedic (Figure 1)
Summary
Venous thromboembolic disease (VTE) is associated with high morbi-mortality. Adherence rate to the recommendations of antithrombotic prophylaxis guidelines (ATPG) is suboptimal. The aim of this study was to describe the adequacy of antithrombotic prophylaxis (ATP) in hospitalized patients as the initial stage of a program designed to improve physician adherence to –ATP recommendations in Argentina. 2 million cases of deep venous thrombosis (DVT) and 200,000 deaths from pulmonary embolism (PE) are reported annually in the United States [1]. These numbers exceed those from breast cancer and AIDS deaths combined [2,3,4]. This paper describes the adequacy of ATP guideline compliance in hospitalized patients as the initial stage of a program designed to improve physician adherence to VTE prophylaxis recommendations
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