Jubelirer Steven J, Reyes Bernardo j, Broce Mike, Elhabyan Abdul-Karim, Mimnagh Kathleen, Rosencrance J Gregory, Warwick Tanya, Emmett Mary K
CAMC Health Education and Research Institute, West Virginia University School of Medicine, Charleston Division, USA.
W V Med J. 2008 Jan-Feb;104(1):10-4.
Venous Thrombembolism (VTE) is a potentially lethal complication in hospitalized patients. Studies indicate that pharmacological prophylaxis may reduce the incidence of VTE. However, the use of VTE prophylaxis remains unclear. We aimed to retrospectively assess whether medically ill hospitalized patients with established risk factors receive pharmacological VTE prophylaxis in our 912-bed community-based tertiary care teaching hospital between 1997 and 2003. We randomly selected a sample of 350 medically ill (non surgical) hospitalized patients with risk factors for VTE. A total of 164 of 321 patients (51.1%) received pharmacological VTE prophylaxis. Patients with a platelet count of greater than or equal to 278 K/cu mm, a weight of 146 to 184 lbs, or a weight > or = 185 lbs were found more likely to receive prophylaxis. Patients with cancer as well as other diagnoses (compared to MI patients) were less likely to receive prophylaxis. We conclude that there continues to be a significant underutilization of VTE prophylaxis in this patient population. Strategies for identifying patients at risk for VTE and implementing appropriate protocols to ensure that these patients receive prophylaxis are necessary.
静脉血栓栓塞症（VTE）是住院患者中一种潜在的致命并发症。研究表明，药物预防可能会降低VTE的发生率。然而，VTE预防措施的使用情况仍不明确。我们旨在回顾性评估在1997年至2003年期间，我们这家拥有912张床位的社区三级护理教学医院中，患有既定风险因素的内科住院患者是否接受了药物性VTE预防。我们随机抽取了350名患有VTE风险因素的内科（非手术）住院患者作为样本。在321名患者中，共有164名（51.1%）接受了药物性VTE预防。血小板计数大于或等于278 K/cu mm、体重在146至184磅之间或体重>或=185磅的患者更有可能接受预防。与心肌梗死患者相比，患有癌症以及其他诊断的患者接受预防的可能性较小。我们得出结论，在这一患者群体中，VTE预防措施的使用仍存在严重不足。有必要制定策略来识别VTE风险患者，并实施适当的方案以确保这些患者接受预防。
