Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/jvb.2014.003
Jornal Vascular Brasileiro
Original Article

Evaluation of thromboprophylaxis in medium-sized general hospital

Avaliação de tromboprofilaxia em hospital geral de médio porte

Cesar Roberto Busato; Ricardo Zanetti Gomes; Dieyson Martins de Melo Costa; Tiago Francisco Meleiro Zubiolo

Downloads: 0
Views: 844

Abstract

CONTEXT: Deep vein thrombosis (DVT) is a serious, common disease whose complications include pulmonary thromboembolism (PTE) and postthrombotic syndrome. The importance and benefits of correct and effective pharmacological prophylaxis for DVT are well documented.OBJECTIVES: The aims of this study were to evaluate adequacy of prophylaxis for DVT and PTE at the Santa Casa de Misericórdia de Ponta Grossa (SCMPG), Paraná, Brazil, and determine risk stratification for patients hospitalized in this institution.METHODS: A cohort study was conducted to assess DVT prophylaxis of patients hospitalized on May 15th, 2009. The study population consisted of a sample of 104 patients, subdivided into clinical and surgical groups and stratified into different specialties. Correct use of DVT prophylaxis was evaluated according to recommendations published by The Brazilian Society for Angiology and Vascular Surgery and took into account prophylactic methods specified explicitly in information found in each patient's medical chart.RESULTS: Of the 104 patients interviewed, 51 (49.04%) were clinical patients and 53 (50.96%) surgical. Based on risk stratification, 17 (16.35%) were classified as low risk, 37 (35.58%) as moderate risk, 46 (44.23%) as high risk and 4 (3.85%) as extremely high risk for DVT/PTE. A total of 68 patients (65.38%) received prophylaxis, but of these only 56 (53.85%) received the correct prophylaxis, and 36 (34.62%) did not receive any prophylaxis.CONCLUSION: The rates of prophylaxis use for DVT and PTE in this service are higher than rates published in the literature.

Keywords

venous thrombosis, venous thromboembolism, pulmonary embolism

Resumo

CONTEXTO: A trombose venosa profunda (TVP) é uma doença frequente e grave, tendo como complicações o tromboembolismo pulmonar (TEP) e a síndrome pós-trombótica. A importância e os benefícios de uma correta e efetiva profilaxia medicamentosa em relação à TVP estão bem documentados.OBJETIVOS: Este trabalho tem por objetivos avaliar a adequação das profilaxias de TVP e TEP na Santa Casa de Misericórdia de Ponta Grossa (SCMPG), Paraná, e estratificar o perfil de risco.MÉTODOS: Realizou-se um estudo de coorte, com a finalidade de avaliar a profilaxia da TVP nos pacientes internados no dia 15 de maio de 2009. Uma amostra de 104 pacientes foi dividida em grupos clínico e cirúrgico, e estratificada em diferentes especialidades. A correta utilização da profilaxia para TVP foi avaliada segundo recomendações da Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV), considerando-se métodos profiláticos presentes nas informações explícitas encontradas na prescrição médica de cada paciente.RESULTADOS: Dos 104 pacientes entrevistados, 51 (49,04%) eram pacientes clínicos e 53 (50,96%) eram cirúrgicos. De acordo com a estratificação do risco, 17 (16,35%) foram classificados como baixo risco, 37 (35,58%) como risco moderado, 46 (44,23%) como alto risco e 4 (3,85%) como altíssimo risco para TVP e TEP. Do total de pacientes, 68 (65,38%) receberam profilaxia, sendo que, deste número, apenas 56 (53,85%) receberam uma profilaxia correta e 36 (34,62%) não receberam nenhuma profilaxia.CONCLUSÕES: As profilaxias de TVP e TEP neste serviço apresentam uma aderência superior aos índices encontrados em trabalhos publicados na literatura.

Palavras-chave

trombose venosa, tromboembolia venosa, embolia pulmonar

References

Garcia ACF, Souza BV, Volpato DE. Reality check: use of deep venous thrombosis prophylaxis: from theory to practice. J Vasc Bras. 2005;4(1):35-41.

Hobson RB, Wilson SE, Veith FJ. Vascular Surgery: Principles and Practice. 2004.

Fowkes FJ, Price JF, Fowkes FG. Incidence of diagnosed deep vein thrombosis in the general population: systematic review. Eur J Vasc Endovasc Surg.. 2003;25:1-5.

Maffei FHA. Trombose venosa profunda dos membros inferiores: incidência, patologia, fisiopatologia e diagnóstico. Doenças vasculares periféricas. 2008.

Baruzzi ACA, Nussbacher A, Lagudis S, Souza JAM. Trombose Venosa Profunda. Arq Bras Cardiol.. 1996;67:3.

Pitta GBB, Leite TL, Silva MDC, Melo CFL, Calheiros GA. Evaluation of the use of prophylaxis for deep venous thrombosis in a teaching hospital. J Vasc Bras. 2007;6:4.

Geerts WH, Pineo GF, Heit JA. Prevention of Venous Thromboembolism The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest.. 2004;126:338S-400S.

Pereira CA, Brito SS, Martins AS, Almeida CM. Deep venous thrombosis prophylaxis: practical application and theoretical knowledge in a general hospital. J Vasc Bras.. 2008;7:1.

Engelhorn ALV, Garcia ACF, Cassou MF, Birckholz L, Engelhorn CA. Deep venous thrombosis prophylaxis: epidemiological study in a medical school hospital. J Vasc Bras.. 2002;1:2.

Nicolaides AN, Breddin HK, Fareed J. Prevention of venous thromboembolism. International Consensus Statement. Guidelines compiled in accordance with the scientific evidence. Int Angiol.. 2001;20(1):1-37.

Rocha AT, Paiva EF, Lichtenstein A. Tromboembolismo Venoso: Profilaxia em Pacientes Clínicos. Projeto Diretrizes. 2005;v. 1.

Maffei FHA, Caiafa JS, Ramacciotti E, Castro AA. Normas de orientação clínica para a prevenção, o diagnóstico e o tratamento da trombose venosa profunda. J Vasc Br. 2005;4(^sSupl.3):S205-20.

Spyropoulos AC. Emerging Strategies in the Prevention of Venous Thromboembolism in Hospitalized Medical Patients. Chest. 2005;128:958-69.

Cogo A, Lensing AW, Prandoni P, Hirsh J. Distribution of thrombosis in patients with symptomatic deep vein thrombosis. Implications for simplifying the diagnostic process with compression ultrasound. Arch Intern Med. 1993;153:2777-80.

Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels. 1994:253-6.

Kearon C. Duration of Venous ThromboembolismProphylaxis After Surgery. Chest. 2003;124:386-92.

Chiasson TC, Manns BJ, Stelfox HT. An Economic Evaluation of Venous Thromboembolism Prophylaxis Strategies in Critically Ill Trauma Patients at Risk of Bleeding. PLoS Med. 2009;6(6).

Tapson VF, Spyropoulos AC, Decousus H. Venous Thromboembolism Prophylaxis in Acutely Ill Hospitalized Medical Patients. Chest. 2007;132:936-45.

Agarwal S, Lee AD, Raju RS, Stephen E. Venous thromboembolism: A problem in the Indian/Asian population?. Indian J Urol. 2009;25:11-6.

Campbell C, Rayner CFJ, Coker RK. Guidelines on prevention of venous thromboembolism during long haul flights. Thorax. 2003;58:91-4.

Meza-Reyes GE, Cymet-Ramirez J, Esquivel-Gómez R. Joint position statement of the Mexican College of Orthopedics and Traumatology: prophylaxis for venous thromboembolic disease in high-risk orthopedic surgery. Acta Ortop Mex. 2011;25(4):216-22.

Samama CM, Gafsou B, Jeandel T. French Society of Anaesthesia and Intensive Care. Guidelines on perioperative venous thromboembolism prophylaxis. Ann Fr Anesth Reanim. 2011;30(12):947-51.

Mandalà M, Falanga A, Roila F. Management of venous thromboembolism (VTE) in cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol. 2011;22(^sSuppl 6):vi85-92.

Holbrook A, Schulman S, Witt DM. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(^s2 Suppl):e152S-84S.

Castro DB, Reck LL, Silvestre OM. Assessment of adherence to thromboprophylaxis protocol in Hospital de Clínicas de Porto Alegre in patients. Rev HCPA & Fac Med Univ Fed Rio Gd Sul. 2006;26(1):12-6.

DiGiovanni CW. Heparin-Induced Thrombocytopenia. Foot & Ankle International. 2008;29:1.

Blann AD, Khoo CW. The prevention and treatment of venous thromboembolism with LMWHs and new anticoagulants. Vasc Health Risk Manag. 2009;5:693-704.

Geerts WH. Prevention of Venous Thromboembolism in High-Risk Patients. Hematology. 2006;6:462-6.

Canonico M, Plu-Bureau G, Lowe GDO, Scarabin PY. Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis. BMJ. 2008;336:1227.

Kawasaki T. Medical Standards Seen from the Perspective of Changes in Academic Society Themes: Investigation of a Lawsuit Concerning the Prevention of Venous ThromboembolismSpecial Article. Ann Vasc Dis.. 2009;2:1.

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
5ddd88cc0e882535561da3e9 jvb Articles

J Vasc Bras

Share this page
Page Sections