Are hospitals delivering appropriate VTE prevention? The venous thromboembolism study to assess the rate of thromboprophylaxis (VTE start)

A. Amin, A. C. Spyropoulos, P. Dobesh, A. Shorr, M. Hussein, E. Mozaffari, J. S. Benner

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

The 7th conference of the American College of Chest Physicians (ACCP7) provides recommendations on the type, dose, and duration of thromboprophylaxis in hospitalized patients at risk of venous thromboembolism (VTE), but the extent to which hospitals follow these criteria has not been well studied. Discharge and billing records for patients admitted to any of 16 acute-care hospitals from January 2005 to December 2006 were obtained. Patients 18 years or older who had an inpatient stay ≥ 2 days and no apparent contraindications for thromboprophylaxis were grouped into the categories of critical care, surgery and medically ill before being assessed for additional VTE risk factors based on the diagnostic criteria outlined in ACCP7. For patients at risk, the recommended type (mechanical or pharmacologic), dose, and duration of thromboprophylaxis was identified based on the guidelines and compared to the regimen actually received, if any. Among the 258,556 hospitalized patients, 68,278 (26.4%) were determined to be at risk of VTE without apparent contraindications for thromboprophylaxis. The proportions of patients who received the appropriate type, dose, and duration of thromboprophylaxis were 10.5, 9.8, and 17.9% for critical care, medical, and surgical patients, respectively. Of those at risk, 36.8% received no thromboprophylaxis and an additional 50.2% received thromboprophylaxis deemed inappropriate for one or more reasons. The implementation of ACCP7 guidelines for type, dosage, and duration of thromboprophylaxis is low in patients at risk of VTE. There is a need for physicians and health systems to improve awareness and implementation of recommended thromboprophylaxis.

Original languageEnglish (US)
Pages (from-to)326-339
Number of pages14
JournalJournal of Thrombosis and Thrombolysis
Volume29
Issue number3
DOIs
StatePublished - Apr 1 2010

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Venous Thromboembolism
Critical Care
Guidelines
Inpatients
Physicians
Health

Keywords

  • Guidelines
  • Health care quality
  • Venous thromboembolism

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

Cite this

Are hospitals delivering appropriate VTE prevention? The venous thromboembolism study to assess the rate of thromboprophylaxis (VTE start). / Amin, A.; Spyropoulos, A. C.; Dobesh, P.; Shorr, A.; Hussein, M.; Mozaffari, E.; Benner, J. S.

In: Journal of Thrombosis and Thrombolysis, Vol. 29, No. 3, 01.04.2010, p. 326-339.

Research output: Contribution to journalArticle

Amin, A. ; Spyropoulos, A. C. ; Dobesh, P. ; Shorr, A. ; Hussein, M. ; Mozaffari, E. ; Benner, J. S. / Are hospitals delivering appropriate VTE prevention? The venous thromboembolism study to assess the rate of thromboprophylaxis (VTE start). In: Journal of Thrombosis and Thrombolysis. 2010 ; Vol. 29, No. 3. pp. 326-339.
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