title: Assessment of characteristics associated with pharmacologic thromboprophylaxis use in hospitalized patients: a cohort study of 10,016 patients.
abstract: The aim of the study was to evaluate patient characteristics associated with pharmacologic thromboprophylaxis (PTP) use/nonuse in a general tertiary hospital cohort. Eligible patients were classified according to venous thromboembolism (VTE) risk category by trained nurses. Either standard or low-molecular weight heparin was recommended to intermediate or high-risk VTE patients. Adopting the recommended PTP was at the physician's discretion. At discharge, PTP use was recorded. PTP was recommended to 10,016 patients, of whom 2165 (21.6%) received the recommended thromboprophylaxis. In the multivariate logistic regression, PTP use/nonuse remained independently associated with female sex [odds ratio (OR) 0.75; 95% confidence interval (CI) 0.68-0.84], age (OR 1.04; 95% CI 1.03-1.04), being admitted to the Gynecology-Obstetrics (OR 0.31; 95% CI 0.25-0.39) or surgery (OR 1.26; 95% CI 1.12-1.42), thrombophilia (OR 5.15; 95% CI 2.04-12.98), previous VTE event (OR 2.98; 95% CI 1.78-4.98), diabetes (OR 1.84; 95% CI 1.61-2.10), acute myocardial infarction (OR 5.87; 95% CI 4.81-7.17), and admission to a major orthopedic surgery (OR 3.03; 95% CI 1.98-4.64). PTP in this hospital population was grossly underused. Eight independent variables predicted use/nonuse of PTP. Targeting variables related to the use and nonuse of PTP is important to direct the application of thromboprophylaxis.
authors.affiliation: aInstituto de Previdência dos Servidores do Estado de Minas Gerais bDepartamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte cDepartamento de Angiologia, Hospital Naval Marcílio Dias, Rio de Janeiro dServiço de Estatística, Departamento de Matemática e Estatística, da Pontifícia Universidade Católica de Minas Gerais eDepartamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Marcos
authors.initials: M
authors.lastname: de Bastos
authors.forename: Sandhi M
authors.initials: SM
authors.lastname: Barreto
authors.forename: Jackson S
authors.initials: JS
authors.lastname: Caiafa
authors.forename: Tânia
authors.initials: T
authors.lastname: Bogutchi
authors.forename: Suely M
authors.initials: SM
authors.lastname: Rezende
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight