Venous thromboembolism prophylaxis in Colombian surgical and medical patients: Results for Colombia of the ENDORSE study
Keywords:
venous thromboembolism/epidemiology, thrombosis/prevention & control, risk manage-ment, general surgery, drug prescriptions
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 patientes.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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References
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16. Scaglione L, Piobbici M, Pagano E. Implementing guidelines for VTE profilaxis in a large Italian teaching hospital: Lights and shadows. Haematologica. 2005;90:678-84.
17. Chopard P, Dorffler-Melly J, Hess U. Venous thromboembolism prophylaxis in acutely ill medical patients: Definite need for improvement. J Intern Med. 2005;257:352-7.
18. Hernández J, Dennis R, Londoño D. Evaluación de la concordancia entre estrategias de profilaxis de TEV en paciente médico en un hospital universitario, Bogotá D.C., 2007-2008. Acta Méd Colomb. 2009;34:4-10.
19. Millar JA. Selection of medical patients for prophylaxis of venous thromboembolism based on analysis of the benefit-hazard ratio. Intern Med J. 2009;39:606-12.
20. Douketis JD. Prevention of venous thromboembolism in hospitalized medical patients: Addressing some practical questions. Curr Opin Pulm Med. 2008;14:381-8.
21. Labarere J, Bosson JL, Sevestre MA. Intervention targeted at nurses to improve venous thromboprophylaxis. Int J Qual Health Care. 2007;19: 301-8.
22. Kucher N, Koo S, Quiroz N. Electronic alerts to prevent VTE among hospitalized patients. N Eng J Med. 2005;352:969-77.
23. Pham DQ, Pham AQ, Ullah E. Evaluating the appropriateness of thromboprophylaxis in an acute care setting using a computerised reminder, through order-entry system. Int J Clin Pract. 2008;62:134-7.
24. Piazza G, Goldhaber SZ. Improving clinical effectiveness in thromboprophylaxis for hospitalized medical patients. Am J Med. 2009;122:230-2.
2. Nieto JA, Monreal M, RIETE Investigators. Recurrent venous thromboembolism in men and women. N Engl J Med. 2004;351:2015-8.
3. Abuabara J, Acero R, Archila PE, Alí A, Bermúdez M, Bohórquez R, et al. II Consenso colombiano de tromboembolismo venoso. Acta Méd Colomb. 2005;30:241-6.
4. Geertz WH, Bergqvitz D, Pineo GF. Prevention of venous thromboembolism. En: The 8th ACCP Conference on Antithrombotic and Thrombolitic Therapy. Chest. 2008;133:381S-453S.
5. Nicolaides AN, Fareed J, Kakkar AK. Prevention and treatment of venous thromboembolism. International consensus statement. Int Angiol. 2006;25:101-61.
6. Dennis R, Acevedo JR, Restrepo H. ¿Es apropiada la profilaxis actual del tromboembolismo venoso en pacientes médicos? Evaluación de desenlaces colombianos en el Registro Internacional sobre Prevención Médica del TEV (IMPROVE). Acta Méd Colomb. 2009;34:11-6.
7. Dennis R, Niño de A MN, Salazar MS. Encuesta nacional sobre tromboembolismo venoso en población hospitalaria. Acta Méd Colomb. 1996;21:55-63.
8. Tapson VF, Decousus H, Pini M. VTE prophylaxis in acutely ill hospitalized medical patients: Findings from the international medical prevention registry on VTE. Chest. 2007;132:936-45.
9. Cohen AT, Tapson VF, Bergmann JF. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study). Lancet. 2008:371:387-94.
10. Samama MM, Cohen AT, Darmon JY. A comparison of enoxaparin with placebo for the prevention of VTE in acutely ill medical patients. N Eng J Med. 1999;341:793-800.
11. Leizorovicz A, Cohen AT, Turpie AG. A randomized placebo controlled trial of dalteparin for the prevention of VTE in acutely ill medical patients. Circulation. 2004;110:874-9.
12. Cohen AT, Davidson BL, Gallus A. Efficacy and safety of fondaparinux for the prevention of VTE in older acute medical patients. BMJ. 2006;332:325-9.
13. Geertz WH, Pineo GF, Heit JA. Prevention of venous thromboembolism: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:338S-400S.
14. Kahn SR, Panju A, Geerts W. Multicenter evaluation of the use of VTE profilaxis in acutely ill medical patients in Canada. Thromb Res. 2007;119:145-55.
15. Menajobsky LB, Spandorfer J. Benefits of more aggressive VTE prophylaxis in hospitalized medical patients. Cleve Clin J Med. 2004;71:947-8.
16. Scaglione L, Piobbici M, Pagano E. Implementing guidelines for VTE profilaxis in a large Italian teaching hospital: Lights and shadows. Haematologica. 2005;90:678-84.
17. Chopard P, Dorffler-Melly J, Hess U. Venous thromboembolism prophylaxis in acutely ill medical patients: Definite need for improvement. J Intern Med. 2005;257:352-7.
18. Hernández J, Dennis R, Londoño D. Evaluación de la concordancia entre estrategias de profilaxis de TEV en paciente médico en un hospital universitario, Bogotá D.C., 2007-2008. Acta Méd Colomb. 2009;34:4-10.
19. Millar JA. Selection of medical patients for prophylaxis of venous thromboembolism based on analysis of the benefit-hazard ratio. Intern Med J. 2009;39:606-12.
20. Douketis JD. Prevention of venous thromboembolism in hospitalized medical patients: Addressing some practical questions. Curr Opin Pulm Med. 2008;14:381-8.
21. Labarere J, Bosson JL, Sevestre MA. Intervention targeted at nurses to improve venous thromboprophylaxis. Int J Qual Health Care. 2007;19: 301-8.
22. Kucher N, Koo S, Quiroz N. Electronic alerts to prevent VTE among hospitalized patients. N Eng J Med. 2005;352:969-77.
23. Pham DQ, Pham AQ, Ullah E. Evaluating the appropriateness of thromboprophylaxis in an acute care setting using a computerised reminder, through order-entry system. Int J Clin Pract. 2008;62:134-7.
24. Piazza G, Goldhaber SZ. Improving clinical effectiveness in thromboprophylaxis for hospitalized medical patients. Am J Med. 2009;122:230-2.
How to Cite
1.
Dennis RJ, Roa JH, Villadiego J, Méndez F, Vieda E, Restrepo H. Venous thromboembolism prophylaxis in Colombian surgical and medical patients: Results for Colombia of the ENDORSE study. biomedica [Internet]. 2011 Mar. 7 [cited 2024 May 16];31(2):200-8. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/304
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