title: Risk of venous thromboembolic disease and adequacy of prophylaxis in hospitalized patients in Argentina: a multicentric cross-sectional study.
abstract: BACKGROUND
  Venous thromboembolic disease (VTE) is associated with high morbi-mortality. Adherence rate to the recommendations of antithrombotic prophylaxis guidelines (ATPG) is suboptimal. The aim of this study was to describe the adequacy of antithrombotic prophylaxis (ATP) in hospitalized patients as the initial stage of a program designed to improve physician adherence to -ATP recommendations in Argentina.
  
  
  METHODS
  This study was a multicenter, cross-sectional study that included 28 Institutions throughout 5 provinces in Argentina.
  
  
  RESULTS
  1315 patients were included, 729 (55.4%) were hospitalized for medical (clinical) reasons, and 586 (44.6%) for surgical reasons. Adequate ATP was provided to 66.9% of the patients and was more frequent in surgical (71%) compared to clinical (63.6%) subjects (p < 0.001). Inadequate ATP resulted from underuse in 76.6% of the patients. Among clinical, 203 (16%) had increased bleeding risk and mechanical ATP was used infrequently.
  
  
  CONCLUSIONS
  The adequacy of ATP was better in low VTE risk clinical and surgical patients and high VTE risk in orthopedic patients. There was worse adequacy in high risk patients (with active neoplasm) and in those with pharmacological ATP contraindications, in which the use of mechanical methods was scarce. The adequacy of ATP was greater at institutions with < 150 beds compared with larger institutions. This is the first multicentric study reporting ATP in Argentina. Understanding local characteristics of medical performance within our territory is the first step in order to develop measures for improving ATP in our environment.
authors.affiliation: Internal Medicine Department, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, (C1181ACH), Buenos Aires, Argentina.
authors.forename: Fernando
authors.initials: F
authors.lastname: Vazquez
authors.affiliation: Chief of Medical Policies, Swiss Medical Medicina Privada, Buenos Aires, Argentina.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Watman
authors.affiliation: Vascular Medicine and Thrombosis Department, Hospital Privado, Córdoba, Argentina.
authors.forename: Aldo
authors.initials: A
authors.lastname: Tabares
authors.affiliation: Hematology Department, Sanatorio Plaza, Rosario, Argentina.
authors.forename: Carina
authors.initials: C
authors.lastname: Gumpel
authors.affiliation: Internal Medicine Department, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: Enrique
authors.initials: E
authors.lastname: Baldessari
authors.affiliation: Hematology Department, Clínica San Camilo, Buenos Aires, Argentina.
authors.forename: Alicia B
authors.initials: AB
authors.lastname: Vilaseca
authors.affiliation: Internal Medicine Department, FLENI, Instituto de Investigaciones Neurológicas Raúl Carrea, Buenos Aires, Argentina.
authors.forename: Federico J
authors.initials: FJ
authors.lastname: Capparelli
authors.affiliation: Internal Medicine, Clínica Santa Isabel, National Coordinator of the Thrombosis-Free Area Argentina Program, Buenos Aires, Argentina.
authors.forename: Esteban
authors.initials: E
authors.lastname: Lifschitz
keywords: Adequacy; Deep vein thrombosis; Pulmonary embolism; Thromboprophylaxis; Thrombosis; Venous thromboembolic disease