Evaluation of the frequency of venous thromboembolism prophylaxis in a selected population of patients hospitalized in nonsurgical wards Results of the all-Poland EPID Registry
Evaluation of the frequency of venous thromboembolism prophylaxis in a selected population of patients hospitalized in nonsurgical wards Results of the all-Poland EPID Registry
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DOI：
10.20452/pamw.626
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发表时间：
2009-03-01
影响因子：
--
通讯作者：
Drzewoski, Jozef
中科院分区：
文献类型：
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作者：
Kasznicki, Jacek;Krupa, Renata;Drzewoski, Jozef
前言：依诺肝素（MEDENOX）预防内科患者血栓形成试验的结果证明了血栓预防在因急性心力衰竭、呼吸衰竭和风湿性疾病住院的患者中的益处。临床实践的分析表明，血栓预防是很少使用这些patients. ACTITIVES评估血栓预防使用选定的人口住院的患者在内部部门在波兰.患者和方法之间的2002年和2006年，14,707住院患者被纳入EPID注册。本分析选择的研究人群包括5246例患者（平均年龄71岁，95% CI：70.6-71.4岁），由60个内部病房报告，符合MEDENOX研究的入选标准。接受长期抗血栓治疗的患者和有开始抗血栓治疗指征的患者未入选。血栓预防的平均持续时间为8.1天（95% CI：7.8-8.4）。在重症监护病房的患者中，81%的患者进行了血栓预防，而非手术部门的患者仅为58%（p < 0.0001）。93%接受预防性治疗的患者使用了低分子量肝素。医生认为出血风险（9.5%）和缺乏血栓预防适应症（27%）是不使用预防性治疗的主要原因。在波兰不同地区，血栓预防的使用频率从35%到89%不等。出血并发症的患者接受professional.CONCLUSIONS管理血栓预防的MEDENOX样人群是非常重要的，从流行病学的角度来看，因为这个病人组占31%的住院病人。血栓预防未得到充分利用，地区间差异很大，应通过对内科医生进行适当的教育计划加以改善。
INTRODUCTION The results of the Prophylaxis in Medical Patients with Enoxoparin (MEDENOX) trial demonstrated the benefit of thromboprophylaxis in patients hospitalized because of acute heart failure, respiratory failure and rheumatic disease. Analysis of clinical practice shows that thromboprophylaxis is rarely used in these patients.OBJECTIVES To assess thromboprophylaxis use in a selected population of patients hospitalized in internal departments in Poland.PATIENTS AND METHODS Between the years 2002 and 2006, 14,707 hospitalized patients were included into the EPID Registry. The study population, selected for the purpose of this analysis, involved 5246 patients (mean age 71, 95% CI: 70.6-71.4 years), reported by 60 internal wards, who met the entry criteria of the MEDENOX study. Patients receiving long-term antithrombotic treatment and patients with indications for initiating antithrombotic treatment were not enrolled.RESULTS Thromboprophylaxis was administered in 63% of patients. The average duration of thromboprophylaxis was 8.1 days (95% CI: 7.8-8.4). In the group of patients admitted to the intensive care unit thromoprophylaxis was administered in 81% of cases compared with 58% in nonsurgical departments (p < 0.0001). Low-molecular-weight heparins were used in 93% of patients receiving prophylaxis. The risk of hemorrhage (9.5%) and lack of indications for thromboprophylaxis (27%) according to the physicians were the main reasons for not using prophylaxis. The frequency of thromboprophylaxis use varied from 35% to 89% between different regions of Poland. Hemorrhagic complications were reported in 0.8% of patients receiving prophylaxis.CONCLUSIONS Administration of thromboprophylaxis in the MEDENOX-like population is of great importance from an epidemiological point of view because this patient group accounts for 31% of in-patients. Thromboprophylaxis is underused with large differences between regions, which should be improved by an adequate educational program for physicians from internal wards.