Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study) : a multinational cross-sectional study  

Oleh:

Cohen, Alexander T. ; Tapson, Victor F. ; Bergmann, Jean-Francois ; Goldhaber, Samuel Z. ; Kakkar, Ajay K. ; Deslandes, Bruno ; Wei, Huang ; Zayaruzny, Maksim ; Emery, Leigh ; Anderson, Frederick A.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Lancet (keterangan: ada di Proquest) vol. 371 no. 9610 (Feb. 2008), page 387.

Ketersediaan

Perpustakaan FK Nomor Panggil: L01.K.2008.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background Information about the variation in the risk for venous thromboembolism (VTE) and in prophylaxis practices around the world is scarce. The ENDORSE ( Epidemiologic International Day for the Evaluation of Patients at Risk for Venous thromboembolism in the Acute Hospital Care Setting) study is a multinational cross-sectional survey designed to assess the prevalence of VTE risk in the acute hospital care setting, and to determine the porpotion of at risk patients who recieve effective prophyylaxis. Methods All hospital inpatients aged 40 years or over admitted to a medical ward, or those aged 18 years or over admitted to a surgical ward, in 358 hospitals across 32 countries were assessed for risk of VTE on the basis of hospital chart review. The 2004 American college of Chest Physicians (ACCP) evidence-based consensus guidelines were used to assess VTE risk and to determine whether patients were receiving recommended prophylaxis. Findings 68183 patients were enrolled; 30827 (45%) were categorised as surgical, and 37356 (55%)as medical. On the basis of ACCP criteria, 35329 (51.8%; 95% Ci 51.4-52.2; between country range 35.6-72.6) patients were judged to be at risk for VTE, including 19842 (64.4%; 63.8-64.9; 44.1-80.2) surgical patients and 15487 (41.5%; 41.0-42.0; 21.1-71.2) medical patients. Of the surgical patients at risk, 11613 (58.5%; 57.8-59.2; 0.2-92.1) recieved ACCP recommended VTE prophylaxis, compared with 3119 (39.5%; 38.7-40.3; 3.1-70.4) at risk medical patients. Interpretation A large proportion of hospitalised patients are at risk for VTE, but there is a low rate of appropriate prophylaxis. Our data reinforce the rationale for the use of hospital-wide strategies to assess patients' VTE risk and toimplement measures that ensure that at risk patients recieve appropriate prophylaxis.

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