Underutilization of venous thromboemoblism prophylaxis in medical patients in a tertiary care center.
BACKGROUND
New recommendations concerning the use of prophylactic anticoagulation for medically ill patients have been in use for some time now. This study aims at assessing how much house-staff in a tertiary care setting are implementing these new recommendations in the hope that through quantitative analysis of the deficiency we would be able to identify areas of weakness.


METHODS
About 250 patients were randomly selected from all patients admitted to the American University of Beirut Medical Center (AUBMC) during the year 2005 and stayed more than 48 h. The risk factor profiles, contraindications to thromboprophylaxis, if present, and whether these patients received the appropriate VTE pharmacologic prophylaxis during their stay in hospital were recorded.


RESULTS
About 139 patients were found to have two or more risk factors, with no absolute contraindications. About 37 patients (26.6%) received VTE prophylaxis. Upon reviewing the risk factors profile, the majority of patients (71.3%) were found to have 2-4 risk factors. Among risk factors studied, age > 40 years, admission to ICU, prior VTE, chronic lung disease, infection, respiratory failure, and central venous catheter were significantly associated with receiving prophylaxis.


CONCLUSIONS
VTE prophylaxis is underutilized at AUBMC, a tertiary care teaching hospital in the Middle East. Critical care patients were being acceptably anti-coagulated, whereas cancer patients are doing the worst.
Masroujeh
Ramy
R
Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon.
Shamseddeen
Wael
W
Isma'eel
Hussain
H
Otrock
Zaher K
ZK
Khalil
Ismail M
IM
Taher
Ali
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D004363:Drug Utilization; D005260:Female; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D007297:Inpatients; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
D000925:Anticoagulants
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