期刊
PHLEBOLOGY
卷 26, 期 8, 页码 344-352出版社
SAGE PUBLICATIONS INC
DOI: 10.1258/phleb.2010.010064
关键词
venous thromboembolism (VTE); thrombosis prophylaxis; surgery; hospital acquired venous thromboembolic disease
资金
- Sanofi-Aventis Turkiye
- KAPPA Consultancy Training Research Ltd (Istanbul, Turkey)
Objective: Venous thromboembolism (VTE) still remains a significant public health problem due to gaps between recommendations and clinical practice in VTE prophylaxis. This is the first clinical study designed to evaluate the applicability of a standard 'VTE prophylaxis and risk factor assessment form (VTE-PRAF)' and prescription of VTE prophylaxis among hospitalized patients in the daily practice of general surgeons in Turkey. Method: A total of 1472 patients (mean age: 52.4 +/- 16.9 years; 50.6% were men) were included in cross-sectional (n = 537), first longitudinal (n = 452) or the second longitudinal (n = 483) phases. Data on demographics, hospitalization, surgical intervention and prophylaxis were collected during the cross-sectional phase, whereas utilization of form was evaluated during longitudinal phases. Results: While 62.1% of patients were identified to be at 'high + highest' risk, prophylaxis was evident only for 65.9%. Utilization of the form was higher in the second longitudinal phase (P < 0.001) but there was no relation between implementation of the form and prophylaxis use. VTE-PRAF was completed for 70.6% and 84.8% of patient who received prophylaxis while it was completed for 50.8% and 50.4% of patients with no prophylaxis, in the first and second longitudinal phases, respectively. Prophylaxis was administered in 58.6% and 62.6% of patients with completed VTE-PRAF in the first and second longitudinal phases, respectively 'Suggested' and 'used' prophylaxis regimens were significantly more consistent for the cases evaluated with VTE-PRAF (P < 0.001). Conclusion: Based on the use of prophylaxis only for 65.9% of general surgery inpatients at high risk for VIE, low use of prophylaxis is assumed to remain a significant threat to public health across Turkey Inclusion of a standard VIE-PRAF in the hospital protocol seems to raise clinical awareness of VIE risk assessment and appropriate management in VTE which otherwise well-known to be associated with significant mortality and morbidity. Impact of e-VTE-PRAF is worth investigating.
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