[Study of epidemiological surveillance of venous thromboembolism prophylaxis in surgical specialties of a school tertiary referral hospital].
BACKGROUND
Postoperative venous thromboembolism is a frequent and severe disease that can lead to pulmonary embolism and post thrombotic syndrome. Although the venous thromboembolism prophylaxis is a proven strategy, an unsuitable indication is observed.


OBJECTIVE
To verify the indication of prophylaxis with heparin among patients of several surgical specialties of a School Tertiary Referral Hospital.


METHODS
It was accomplished a prospective study during 10 consecutive days in each month, from September to December of 2005, with 360 patients surgically treated in the specialties: General Surgery, Gynecology, Neurosurgery, Ortopedy and Traumatology, Urology and Angiology and Vascular Surgery, identifying risk factors for the development of venous thromboembolism (VTE) and the use of heparin prophylaxis according to the recommendations of the Brazilian Society of Angiology and Vascular Surgery.


RESULTS
Three hundred and fifty seven patients were evaluated, 24 (6,7%), 128 (35,9%) and 205 (57,4%) were included in low risk, medium risk and high risk for venous thromboembolism, respectively. One hundred and eighty four patients (51,5%) of the sample received prophylactic heparin. Heparin was used in 73,3% of the patients of General Surgery, 16,7% of Gynecology, 50,0% of Neurosurgery, 32,5% of Ortopedy and Traumatology, 37,3% of Urology and 97,7% of Angiology and Vascular Surgery. Only 38,3% of medium risk and 64,4% of high risk patients received prophylactic heparin. Heparin was suitably used in 77,6% of medium risk and in 63,6% of high risk patients. Thrombocytopenia, minor bleeding and major bleeding occurred in 3 (1,6%), 12 (6,5%) and 2 (1,1%) of the patients, respectively. Thromboembolic complications occurred in 6 (1,7%) cases.


CONCLUSIONS
Although the indications of prophylactic heparin to venous thromboembolism are well known, we verify an incomplete adhesion of medical professionals, exposing patients to severe complications.
Diogo-Filho
Augusto
A
Departamento de Cirurgia da Faculdade de Medicina, Universidade Federal de Uberlândia, MG. diogofilho@netsite.com.br
Maia
Cíntia Prado
CP
Diogo
Débora Miranda
DM
Fedrigo
Larissa dos Santos Paula
Ldos S
Diogo
Priscila Miranda
PM
Vasconcelos
Priscila Meira
PM
D000925:Anticoagulants / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D019983:Guideline Adherence; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D010818:Practice Patterns, Physicians'; D013043:Specialties, Surgical / Q000706:statistics & numerical data; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
D000925:Anticoagulants; D006493:Heparin