[Venous thromboembolism prophylaxis in Colombian surgical and medical patients: results for Colombia of the ENDORSE study]
Dennis, Rodolfo J. ; Roa, Jairo H. ; Villadiego, Juan ; Mendez, Freddy ; Vieda, Elias ; Restrepo, Hector
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Colombia
Female
Guideline Adherence
Hospitals
Humans
*Inpatients
Middle Aged
*Risk Assessment
Risk Factors
Venous Thromboembolism
venous thromboembolism/epidemiology
thrombosis/prevention & control
risk management
general surgery
drug prescriptions
Cardiovascular Diseases
Clinical Epidemiology
Epidemiology
Health Services Research
Therapeutics
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Abstract
INTRODUCTION: More information is needed on the risk of venous thromboembolism in the hospital setting, and on patterns of use of thromboprophylaxis, as advocated in consensus guidelines.ENDORSE was an international study aimed at evaluating hospital venous thromboembolism prevention practices in medical and surgical patients.
OBJECTIVES: The risk of venous thromboembolism was evaluated along with the use of thromboprophylaxis in hospitalized medical and surgical subjects; these data were compared with the international sample from the ENDORSE study.
MATERIALS AND METHODS: Participating institutions in Colombia were selected arbitrarily. The medical charts for medical and surgical patients were evaluated randomly. The 2004 American College of Chest Physician guidelines were used to evaluate risk of venous thromboembolism and adherence to recommended thromboprophylaxis regimens.
RESULTS: The study included 761 subjects (218 surgical, 543 medical) located in five acute care hospitals; 49% of these subjects were considered at risk of venous thromboembolism (40% medical, 72% surgical), compared with 52% in the international sample. Prophylaxis use was higher in medical patients at risk (63.7%, n = 137) than in surgical patients (48.4%, n = 76; p = 0.01). Compared with the international sample, the use of prophylaxis in Colombia was greater in medical patients (63.7% vs. 39.5%, p = 0.003), but lower in surgical patients (48.4% vs. 58.5%, p = 0.02).
CONCLUSIONS: Participating Colombian centers treat patients at risk of venous thromboembolism similarly to other participant countries, but appropriate prophylaxis was prescribed more frequently to medical patients. Greater efforts are needed, both in Colombia and around the world, to improve rates of appropriate venous thromboembolism prophylaxis in at-risk subjects.
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Biomedica. 2011 Jun;31(2):200-8. doi: 10.7705/biomedica.v31i2.304. Link to article on publisher's site
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Article is in Spanish with an abstract in English.