Survey of the use of thromboprophylaxis for medical patients at Christchurch Hospital.

AIM

To determine the level of utilisation of thromboprophylaxis in relation to risk factors for medical patients at Christchurch Hospital.

METHODS

All medical wards were surveyed three times over a 12-week period from January 1998. Patients currently under investigation for venous thromboembolism were excluded, as were those currently receiving anticoagulant treatment for unrelated disorders. Primary prophylaxis was defined as the use of low-dose heparins or elastic stockings in asymptomatic patients. Patients with two or more risk factors were defined as being at high risk.

RESULTS

Three hundred and eighty-seven patients were interviewed, of whom 80% were considered to be potentially eligible for primary prophylaxis. One hundred and one patients (33%) were at high risk, of whom 20 (20%) were given primary prophylaxis. Cancer, confinement to bed, recent surgery and heart failure were the most common risk factors. Elastic stockings and low-dose heparin were employed in the same proportion of high risk cases but no patient received both. Patients with cancer were less likely to receive thromboprophylaxis than those with the other risk factors. Overall, only about 7% of high-risk patients received thromboprophylaxis for more than 75% of the duration of their stay in hospital.

CONCLUSION

Thromboprophylaxis is underutilised at Christchurch Hospital. Guidelines are required and audits of compliance are indicated.