Egermayer P, Robins C, Town G I
Canterbury Respiratory Research Group, Christchurch School of Medicine.
N Z Med J. 1999 Jul 9;112(1091):246-8.
To determine the level of utilisation of thromboprophylaxis in relation to risk factors for medical patients at Christchurch Hospital.
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.
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.
Thromboprophylaxis is underutilised at Christchurch Hospital. Guidelines are required and audits of compliance are indicated.
确定克赖斯特彻奇医院内科患者血栓预防措施的使用水平与风险因素之间的关系。
从1998年1月开始的12周内，对所有内科病房进行了三次调查。目前正在接受静脉血栓栓塞症调查的患者以及目前因无关疾病接受抗凝治疗的患者被排除在外。一级预防被定义为对无症状患者使用低剂量肝素或弹力袜。有两个或更多风险因素的患者被定义为高危患者。
对387名患者进行了访谈，其中80%被认为有资格接受一级预防。101名患者（33%）为高危患者，其中20名（20%）接受了一级预防。癌症、卧床、近期手术和心力衰竭是最常见的风险因素。在高危病例中，使用弹力袜和低剂量肝素的比例相同，但没有患者同时接受这两种预防措施。与其他风险因素的患者相比，癌症患者接受血栓预防的可能性较小。总体而言，只有约7%的高危患者在住院期间超过75%的时间接受了血栓预防。
克赖斯特彻奇医院对血栓预防措施的使用不足。需要制定指南并进行依从性审计。
