[Venous thromboembolism risk and antithrombotic prophylaxis among patients admitted to Spanish hospitals (ENDORSE study)]
Center for Outcomes Research
Medical Subject Headings
Aged; Cross-Sectional Studies; Female; Fibrinolytic Agents; *Hospitalization; Humans; Male; Risk Factors; Spain; Venous Thromboembolism
Health Services Research
BACKGROUND AND OBJECTIVES: The proportion of patients at risk of venous thromboembolism (VTE) in Spanish hospitals and, among those, the proportion who receive prophylaxis are not well known. The objective of this study was to obtain this information by means of the analysis of data from the Spanish centres that participated in the international ENDORSE study.
METHODS: Cross-sectional study in 20 Spanish hospitals. VTE risk factors and VTE prophylaxis were assessed in all hospital inpatients, aged 18 years or over, admitted to a surgical ward, and 40 years or over admitted to a medical ward. The 7th Conference of the American College of Chest Physicians (ACCP) guidelines and recommendations were used as a reference to assess risk categories and the prophylaxis given to patients.
RESULTS: 6.554 hospital beds were assessed, and 3.809 inpatients were enrolled; 2.069 (67,5%) were medical and 996 (32,5%) surgical. Based on the ACCP criteria, 1.878 (61,3%) were at risk for VTE, 1.140 (55,1%) were medical and 738 (74,1%) were surgical. According to the ACCP guidelines and recommendations, 731 medical patients at risk of VTE (64,1%, 95% CI 61,3%-66,9%) received appropriate prophylaxis, as compared to 605 (82%; 95% CI 79,2%-84,8%) surgical patients (p<0,001).
CONCLUSIONS: VTE prophylaxis in the Spanish centres was more common in surgical patients than in medical patients. Nevertheless, it is still necessary to extend the VTE prophylaxis to a significant number of patients (29%) at high risk of VTE, particularly in medical wards.
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Citation: Med Clin (Barc). 2009 Jun 6;133(1):1-7. Epub 2009 May 15. Link to article on publisher's site