title: PROF-ETEV study: prophylaxis of venous thromboembolic disease in critical care units in Spain.
abstract: OBJECTIVE
  Venous thromboembolic disease (VTE) in critically ill patients has a high incidence despite prophylactic measures. This fact could be related to an inappropriate use of these measures due to the absence of specific VTE risk scores. To assess the current situation in Spain, we have performed a cross-sectional study, analyzing if the prophylactic measures were appropriate to the patients' VTE risk.
  
  
  METHODS
  Through an electronic questionnaire, we carried out a single day point prevalence study on the VTE prophylactic measures used in several critical care units in Spain. We performed a risk stratification for VTE in three groups: low, moderate-high, and very high risk. The American College of Chest Physicians guidelines were used to determine if the patients were receiving the recommended prophylaxis.
  
  
  RESULTS
  A total of 777 patients were included; 62% medical, 30% surgical, and 7% major trauma patients. The median number of the risk factors for VTE was four. According to the proposed VTE risk score, only 2% of the patients were at low risk, whereas 83% were at very high risk. Sixty-three percent of patients received pharmacological prophylaxis, 12% mechanical prophylaxis, 6% combined prophylaxis, and 19% did not receive any prophylactic measure. According to criteria suggested by the guidelines, 23% of medical, 71% of surgical, and 70% of major trauma patients received an inappropriate prophylaxis.
  
  
  CONCLUSIONS
  Most critically ill patients are at high or very high risk of VTE, but there is a low rate of appropriate prophylaxis. The efforts to improve the identification of patients at risk, and the implementation of appropriate prevention protocols should be enhanced.
authors.affiliation: Intensive Care Unit, Gregorio Marañón Universitary Hospital, Doctor Esquerdo 45, 28028, Madrid, Spain, garciaolivaresp@gmail.com.
authors.forename: Pablo
authors.initials: P
authors.lastname: García-Olivares
authors.forename: Jose Eugenio
authors.initials: JE
authors.lastname: Guerrero
authors.forename: Pedro
authors.initials: P
authors.lastname: Galdos
authors.forename: Demetrio
authors.initials: D
authors.lastname: Carriedo
authors.forename: Francisco
authors.initials: F
authors.lastname: Murillo
authors.forename: Antonio
authors.initials: A
authors.lastname: Rivera
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013923:Thromboembolism / Q000453:epidemiology / Q000517:prevention & control*