title: [Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): results obtained in France].
abstract: OBJECTIVE
  Information about the variation in the risk for venous thromboembolism (VTE) and in prophylaxis practices in France and around the world is scarce.
  
  
  METHODS
  The Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting (ENDORSE) study is a multinational cross-sectional survey designed to assess the prevalence of VTE risk in the acute hospital care setting, and to determine the proportion of at-risk patients who receive effective prophylaxis, in accordance with the 2004 American College of Chest Physicians (ACCP) guidelines. This paper gives the results of the ENDORSE study in the French centres in comparison with the global worldwide results of the ENDORSE study and with other Western Europe countries.
  
  
  RESULTS
  In France, 18 randomized hospitals participated to the study between august 2006 and January 2007. 2844 patients were evaluated (917 from chirurgical wards and 1927 from medical wards). One thousand four hundred and nineteen patients (49.9%) were at VTE risk (78.3% in chirurgical wards and 36.4% in medical wards). Of the 1419 patients at VTE risk, 62.4% received ACCP-recommended VTE prophylaxis (71.2% in chirurgical wards and 53.5% in medical wards). VTE Prophylaxis in France (62.4%) is more frequent than worldwide in the international ENDORSE study (50.2%) and similar to the majority of the other western European countries and the USA. It is also more used in university hospitals (66.9%) than in other hospitals (58.9%). Prophylaxis in patients at risk for VTE was presented in 43% patients with acute heart failure, 53% with non-infectious acute respiratory failure, 57% in patients with pulmonary infection, 56% in patients with stroke, 55% in patients with active cancer and 48% in patients with non-pulmonary sepsis.
  
  
  CONCLUSIONS
  The ENDORSE study has shown a high level of patients at risk for VTE in the population of hospitalized patients in France. The rate of prophylaxis for VTE remained low, in particular in Medicine wards. Our data reinforced the rationale for the use of hospital-wide strategies to assess patients' VTE risk and to implement measures that ensure that at-risk patients receive appropriate prophylaxis, in particularly in medical patients.
authors.affiliation: Université Paris-Diderot, AP-HP, hôpital Lariboisière, service médecine interne A, 75010 Paris, France. jf.bergmann@lrb.aphp.fr
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bergmann
authors.forename: Célia
authors.initials: C
authors.lastname: Lloret-Linares
authors.forename: Agathe
authors.initials: A
authors.lastname: Rami
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Cohen
authors.forename: Ricardo P
authors.initials: RP
authors.lastname: Garay
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Kakkar
authors.forename: Samuel Z
authors.initials: SZ
authors.lastname: Goldhaber
authors.forename: Bruno
authors.initials: B
authors.lastname: Deslandes
authors.forename: Victor F
authors.initials: VF
authors.lastname: Tapson
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000925:Anticoagulants / Q000627:therapeutic use; D018890:Chemoprevention / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D014943:Global Health / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011364:Professional Practice / Q000706:statistics & numerical data; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants