Audit of anticoagulant thromboprophylaxis in hospitalized oncology patients.
BACKGROUND
Venous thromboembolism (VTE) is a significant problem in oncology patients. VTE prophylaxis is underutilized in hospitalized medical patients, but there are few data for the appropriateness and frequency of its use in the oncology subgroup. We aimed to document local practice.


METHODS
A cross-sectional chart review of all hospitalized patients cared for by the Christchurch Hospital Oncology Service was carried out during two defined 4-week periods. Assessment for indications and contraindications to prophylactic anticoagulation was based on the 2004 American College of Chest Physicians evidence-based consensus guidelines.


RESULTS
Of 113 admissions to the oncology service, 38 (33.6%) had indications for prophylactic anticoagulation. However, 23 of these also had contraindications, leaving only 15 (13%) admissions where prophylactic anticoagulation was deemed appropriate. Only one was appropriately given prophylactic anticoagulation.


CONCLUSIONS
Only a minority of hospitalized oncology patients are appropriate for prophylactic anticoagulation. Where it is suitable, however, it is poorly utilized locally. Local promotion of VTE prophylaxis and further study of this subgroup of hospitalized medical patients may improve uptake of this practice and attenuate morbidity from VTE.
Chin
P K L
PK
Diabetes Centre, Christchurch Hospital, Christchurch, New Zealand. paulchinnz@gmail.com
Beckert
L E L
LE
Gunningham
S
S
Edwards
A L
AL
Robinson
B A
BA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D003133:Commission on Professional and Hospital Activities; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010818:Practice Patterns, Physicians'; D020246:Venous Thrombosis / Q000517:prevention & control*
D000925:Anticoagulants