Venous thromboembolism risk and prophylaxis in the acute hospital care setting--results of the ENDORSE study in Poland
Center for Outcomes Research
Medical Subject Headings
Adult; Aged; Anticoagulants; Cross-Sectional Studies; Female; Fibrinolytic Agents; Hospitals; Humans; Inpatients; Male; Medical Audit; Middle Aged; Outcome Assessment (Health Care); Patient Care Management; Poland; Postoperative Complications; Risk Assessment; Thromboembolism; Venous Thrombosis
Health Services Research
INTRODUCTION: Venous thromboembolism (VTE) is the most common preventable cause of in-hospital death. However, the risk of VTE and prophylaxis practices in Polish hospitals are not known.
OBJECTIVES: The ENDORSE study in Poland was part of the global cross-sectional Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting survey with the objective to assess the prevalence of VTE risk in acutely ill medical and surgical patients and to determine the proportion of at-risk patients who receive recommended prophylaxis.
PATIENTS AND METHODS: In 10 non-academic Polish hospitals, a chart review was performed in all inpatients aged 40 or older admitted to medical wards, and in patients at the age of > or = 18 admitted to surgical wards. The VTE risk and recommended prophylaxis were assessed according to the 2004 American College of Chest Physicians (ACCP) guidelines.
RESULTS: The study enrolled 2673 patients (1092 in surgical wards, 1581 in medical wards). Out of these, 1111 were judged to be at risk for VTE (597 surgical patients, 514 medical patients). Only 51.8% of all at-risk patients received ACCP-recommended VTE prophylaxis (54.7% of surgical patients, 32.5% of medical patients).
CONCLUSIONS: In Polish hospitals more than 40% of patients hospitalized for acute illness are at risk of VTE, but only a small proportion of them receives appropriate prophylaxis. These results call for decisive actions to ensure that at-risk patients receive recommended VTE prophylaxis.
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Citation: Pol Arch Med Wewn (Polish Archives of Internal Medicine). 2008 Oct;118(10):555-61.