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GRP-052 Does an Increase in the Use of Low Molecular Weight Heparin Thromboprophylaxis Correspond to a Decrease in the Incidence of Hospital-Acquired Venous Thromboembolism?
  1. L Hammond,
  2. F Kennedy,
  3. N O’Hanlon,
  4. J O’Shea
  1. St. Vincent’s University Hospital, Pharmacy Department, Dublin, Ireland (Rep.)

Abstract

Background Venous thromboembolism (VTE) is a common complication of hospital admission. Pulmonary Embolism (PE) accounts for 5–10% of deaths in hospitalised patients and is the most common cause of preventable hospital mortality. Prophylactic Low-Molecular-Weight heparin (LMWH) reduces the risk of VTE but is widely under-prescribed. Although LMWH prophylaxis in SVUH has been cyclically audited since 2007, the use of thromboprophylactic LMWH has not been studied in comparison to the incidence of hospital-acquired VTE.

Purpose To measure the use of LMWH thromboprophylaxis and to compare this to the rate of confirmed hospital-acquired VTE.

Materials and Methods The pharmacy dispensing and stock management system provided data on the use of thromboprophylactic LMWH from 2007 onwards. Data on the incidence of hospital-acquired VTE was collected from the Hospital Information System. These figures were compared with one another.

Results The rate of use of thromboprophylactic LMWH in SVUH rose by 26% over the study period. The average incidence of hospital-acquired VTE was 8.3 (range 6.8–9.3) per 1,000 inpatient admissions over the same period. This average is consistent with published rates, but the incidence in SVUH increased over the study period.

Conclusions Hospital-acquired VTE is a major public health issue and is associated with substantial morbidity and mortality. Appropriate thromboprophylaxis is considered to be the most effective strategy for preventing VTE. Although the use of LMWH thromboprophylaxis in SVUH increased steadily over the study period, the incidence of VTE also increased over the same period, suggesting that there are other factors (e.g. patient complexity, inappropriate LMWH dosing etc.) influencing the rate of hospital-acquired VTE. Audit of LMWH thromboprophylaxis is a useful tool to assess awareness and compliance with in-hospital VTE prophylaxis guidelines. Trends in the incidence of hospital-acquired VTE may be helpful in assessing the effectiveness of in-hospital thromboprophylaxis, when other factors are taken into consideration.

No conflict of interest.

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