Venous thromboembolism risk factors and practices of prophylaxis: ENDORSE study results in Portugal.
BACKGROUND
Venous thromboembolism (VTE) risk assessment is a cornerstone for the achievement of best practices and outcomes. Epidemiologic data and practices related to venous thromboprophylaxis as considered by the global ENDORSE study, (Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting), enrolled 68,183 patients from 32 countries, in which Portugal. Within ENDORSE, data from all participant countries analyzed to determine their risk of VTE and to evaluate the suitability of prophylaxis.


METHODS
European patients were enrolled from randomly selected hospitals in Portugal (European Hospital Register), according to ENDORSE study inclusion/exclusion criteria. The Seventh ACCP evidence-based consensus guidelines were employed to evaluate VTE risk and prophylaxis use.


RESULTS
From a total of 3,145 beds assessed, 2,183 were considered eligible and 1,632 met all criteria. Of these, 860 (52.7%; 95% CI 50.3-55.1) were at risk of VTE: 525 surgical patients (68.9%; 95% CI 65.5-72.1) and 335 medical patients (38.5%; 95% CI 35.3-41.2). The rate of prophylaxis according to ACCP guidelines in overall patients at risk was 58.5% (503 patients). The prophylaxis rate for VTE was 59% (310 patients) in surgical patients and 57.6% (n=193) in medical patients. 39.7% of surgical patients and 39.4 % of medical patients who did not meet the criteria for prophylaxis were also on prophylaxis with an anticoagulant, which was considered to be inappropriate.


CONCLUSIONS
More than a half of these hospitalized patients in Portugal were deemed at risk of VTE and less than two-thirds of them received appropriate prophylaxis. New strategies are required for implementation of venous thromboprophylaxis in Portuguese hospitals.
Internal Medicine Service, Hospital Garcia de Orta, Almada, Portugal.
Ana
A
França
Abílio
A
Reis
Aida
A
Paulino
Corina
C
Lohman
Daniel
D
Cartucho
Glória
G
Campello
Luísa
L
Morais
Pedro
P
Moreira
Rui
R
Abreu
Tiago
T
Abreu
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D011174:Portugal; D010818:Practice Patterns, Physicians'; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control*