[Prevention of venous thromboembolism. Survey of in-hospital medical practice].
OBJECTIVE
In an effort to improve the prevention of venous thromboembolism, the Nancy University Hospitals conducted a survey of medical practice concerning indications for preventive therapy and surveillance of platelet counts and anti Xa activity.


METHODS
The survey involved 163 medical files. Questionnaires were filled out in 6 units (3 medical wards and 3 intensive care units).


RESULTS
Indications for preventive therapy were found to be quite variable with the exception of very low risk of thromboembolism where the treat/do not treat ratio was 0.1/1, indicating a clear tendency for abstention. This ratio was 0.77/1 and 0.38/1 respectively for low and moderate risk and 2/1 for high risk. There was undoubtedly a ward effect. The attitudes in practice tended toward non-prevention in patients without limited mobility. For platelet counts, an initial count was performed in 95% of the cases and during treatment in 38% although the specific rates were not the same for different types of units. Anti-Xa activity, which according to prevention recommendations need not to be determined, was not monitored in 88% of the cases. In accordance with prevention recommendations, anti-Xa activity was not determined in 88% of the cases.


CONCLUSIONS
Further progress is needed in the prevention of venous thromboembolism and should be based on wider use of existing methods.
Lepaux
D J
DJ
Centre hospitalier régional universitaire de Nancy.
Wahl
D
D
Schuhmacher
H
H
Nace
L
L
Angioi
M
M
Briançon
S
S
Delorme
N
N
Laurain
M C
MC
Maurer
P
P
Pinelli
C
C
Lecompte
T
T
D005602:France / Q000453:epidemiology; D006801:Humans; D013923:Thromboembolism / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D013924:Thrombophlebitis / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*
Prévention de la maladie thromboembolique veineuse. Enquête sur les pratiques en milieu médical hospitalier.