Background Venous thromboembolism (VTE) in adults is associated with high morbidity and mortality. However, adherence to standards of prophylaxis care is not always optimal in medical units.
Purpose To analyse the adequacy of VTE prophylaxis in clinical practice in a cross sectional study.
Material and methods A review of thromboprophylaxis standards and assessment of the adequacy of these guidelines in medical units was conducted. The analysis was carried out in all patients admitted to medical units. The risk of VT in hospitalised nonsurgical patients was estimated using the scale of Padua. According to the scale, the adequacy of prophylaxis at the care units was established.
Results 87 of the total patients admitted to the medical services (excluding paediatric, intensive care and intermediate care services) were analysed. 26.4% (23) of patients were receiving anticoagulant therapy for different reasons. 65% of the remainder (73.6%) were men and the average age was 69.6±13.4 years. The patients analysed belonged to the following services: internal medicine 30%, neurology 19%, digestive 15.6%, nephrology 14.1%, cardiology 11%, rehabilitation 6.3% and pneumology 4.7%. 37.5% (24) of patients had no prophylaxis, 11% (17.2) had low dose prophylaxis and 45% (29) had high dose prophylaxis. Drugs used for prophylaxis were: enoxaparin 80.4% and bemiparin 19.6%. 28% of patients achieved ≤3 points and 72% 4–10 points on the scale of Padua. In addition, 32.8% (21) wandered and 67.2% (43) did not. Regarding the adequacy of prophylaxis, 72% of treatments were correct. In 17 cases (35% of nephrology and 35% of internal medicine) the prophylactic treatment was incorrect. The reasons were: lack of prophylaxis in patients in whom it was necessary (6), sub-therapeutic doses (6) and patients who had prophylaxis but did not need it (5).
Conclusion This transversal analysis allowed us to detect areas where an improvement in some aspects of thromboprophylaxis is necessary. To ensure proper prophylaxis of medical patients, it is necessary to establish recommendations and to disseminate these recommendations. A programme of pharmaceutical care of thromboembolic prophylaxis has been agreed in internal medicine and nephrology, areas in which a greater lack of adherence to guidelines and recommendations for prophylaxis has been detected.
No conflict of interest
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