[Assessing the use of low-molecular-weight heparins fo venous thromboembolism prophylaxis in internal medicine patients].
BACKGROUND
Sufficient evidence exists to recommend routine thromboembolic disease prophylaxis for medical inpatients with risk factors --with low-molecular-weight-- heparins being (LMWH) the most suitable treatment option. The objective is to determine the thromboembolic risk level of Internal Medicine patients with LMWH prophylaxis, prescription habits and their adequacy to hospital's standards, as well as prevalence of non-treated patients at risk.


METHODS
Descriptive and prospective study of internal medicine patients for 2 months. Patients with prophylactic LMWH prescription were chosen, and their thromboembolic risk level and suitable LMWH dose was determined according to the hospital's "thromboembolic disease prevention standards". On the other hand, patients with no LMWH prophylaxis were analysed in order to judge their candidacy.


RESULTS
30% of patients had a prophylactical LMWH prescription, with 43.5% of these prescriptions being adequate to the risk level. The main risk factors were: age, bed-stay, hypertension, cardiopathy with risk factors, diabetes mellitus, dislipemias and COPD. Chi2(0.05) test between risk level and prescribed LMWH revealed no association. 72% of patients without LMWH prescription had a moderate or high risk level.


CONCLUSIONS
1. A high proportion of the patients studied have a considerable thromboembolic risk level. 2. There is not a statistical relationship between thromboembolic risk level and LMWH prescription. 3. There is a high percentage of patients with no LMWH prophylaxis which could be eligible for it. 4. A pharmaceutical intervention would be useful to approach pharmacological prophylaxis to each patient's risk.
Villar Fernández
I
I
Servicio de Farmacia, Hospital Miguel Servet, Zaragoza. ivillar@salud.aragob.es
Urbieta Sanz
E
E
Arenere Mendoza
M
M
López Larramona
G
G
Marcilla Córdoba
F
F
Rabanaque Hernández
M J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D013923:Thromboembolism / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight