Evaluation of thromboprophylaxis in patients hospitalized in a tertiary care center: An applicable model of clinical practice evaluation. Revision of 320 cases
Evaluation of thromboprophylaxis in patients hospitalized in a tertiary care center: An applicable model of clinical practice evaluation. Revision of 320 cases
复制标题
DOI：
10.1016/j.jmv.2010.10.005
复制
发表时间：
2011-02-01
影响因子：
--
通讯作者：
Touchette, M.
中科院分区：
文献类型：
--
作者：
Lanthier, L.;Bechard, D.;Touchette, M.
目标. - 分析有静脉血栓栓塞风险的患者的院内血栓预防。评估这些患者对肝素诱导血小板减少症筛查建议的依从性。- 我们对395名在我们三级护理中心住院的有静脉血栓栓塞风险的患者进行了一项横断面研究。我们收集了关于血栓预防的数据（血栓形成的危险因素、预防类型、出血风险、人口统计学数据和住院数据）。- 320例患者纳入研究; 183例患者在内科病房住院，137例患者在外科病房住院。根据美国胸科医师学会的临床实践指南，57%的患者需要血栓预防。83.7%的患者（76.1%的内科病例和90.6%的外科病例）接受了充分的静脉血栓预防治疗。相比之下，只有47.1%的家庭医学病房的高危患者接受了充分的预防。79.3%有需要的患者接受了适当的血小板计数监测。结论。- 血栓预防的使用在我们的机构中得到了很好的确立。在回顾了这些数据后，我们制定了措施来提高我们的适当血栓预防和血小板计数监测率。这种类型的评估可以考虑由其他中心，以评估他们的表现和机构的措施，以提高他们的护理质量。(C)2010年Elsevier Masson SAS。All rights reserved.
Objectives. - To analyze in-hospital thromboprophylaxis in patients at risk for venous thromboembolism. To evaluate compliance with heparin-induced thrombocytopenia screening recommendations in these patients.Patient and methods. - We performed a cross-sectional study of 395 patients hospitalized in our tertiary care center at risk for venous thromboembolism. We collected data regarding thromboprophylaxis (risk factors for thrombosis, type of prophylaxis, bleeding risk, demographic data, and hospitalization data).Results. - Three hundred and twenty patients were included in the study; 183 patients were hospitalized on medical wards and 137 patients on surgical wards. Thromboprohylaxis was indicated in 57% of the patients according to the American College of Chest Physicians' clinical practice guidelines. Adequate venous thrombosis prophylaxis was prescribed for 83.7% of these patients (76.1% of medical cases and 90.6% of the surgical cases). In contrast, only 47.1% of at risk patients on the family medicine wards received adequate prophylaxis. 79.3% of patients for whom it was indicated underwent appropriate platelet count monitoring.Conclusion. - The use of thromboprophylaxis is well established in our institution. After having reviewed these data we instituted measures to improve our rate of appropriate thromboprophylaxis and platelet count monitoring. This type of evaluation could be considered by other centers in order to evaluate their performance and institute measures to improve their quality of care. (C) 2010 Elsevier Masson SAS. All rights reserved.