Physician practices in the prevention of venous thromboembolism.

Abstract:

OBJECTIVE:To determine the rate of use of prophylaxis for venous thromboembolism in high-risk hospital patients. DESIGN:A retrospective medical record review. SETTING:A community-wide study in 16 short-stay hospitals in central Massachusetts. PATIENTS:A total of 2017 patients with multiple risk factors for venous thromboembolism. MEASUREMENTS AND MAIN RESULTS:On the basis of age, length of hospitalization, and the presence of at least one additional major risk factor, 17% of 151,349 discharges (25,410 patients) were identified as being at high risk for venous thromboembolism. Eight percent of these discharges were randomly selected for medical record review. Prophylaxis for venous thromboembolism was received by 32% of these high-risk patients. Prophylaxis use among the 16 study hospitals varied widely, ranging from 9% to 56%, and was higher in teaching hospitals than in nonteaching hospitals (44% compared with 19%; P less than 0.001). One or more of the following methods of prophylaxis was used: low-dose heparin (78%), intermittent calf compression (13%), warfarin (12%), and inferior vena caval filter (3%). Use of prophylaxis increased with the number of risk factors identified (P less than 0.001). CONCLUSION:Prophylaxis for venous thromboemobolism is underused, particularly in nonteaching hospitals.

journal_name

Ann Intern Med

authors

Anderson FA Jr,Wheeler HB,Goldberg RJ,Hosmer DW,Forcier A,Patwardhan NA

doi

10.7326/0003-4819-591

subject

Has Abstract

pub_date

1991-10-15 00:00:00

pages

591-5

issue

8

eissn

0003-4819

issn

1539-3704

journal_volume

115

pub_type

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