Diabetes Centre, Christchurch Hospital, Christchurch, New Zealand.
Intern Med J. 2009 Dec;39(12):819-25. doi: 10.1111/j.1445-5994.2008.01828.x. Epub 2008 Nov 3.
Venous thromboembolism (VTE) is a significant problem in oncology patients. VTE prophylaxis is underutilized in hospitalized medical patients, but there are few data for the appropriateness and frequency of its use in the oncology subgroup. We aimed to document local practice.
A cross-sectional chart review of all hospitalized patients cared for by the Christchurch Hospital Oncology Service was carried out during two defined 4-week periods. Assessment for indications and contraindications to prophylactic anticoagulation was based on the 2004 American College of Chest Physicians evidence-based consensus guidelines.
Of 113 admissions to the oncology service, 38 (33.6%) had indications for prophylactic anticoagulation. However, 23 of these also had contraindications, leaving only 15 (13%) admissions where prophylactic anticoagulation was deemed appropriate. Only one was appropriately given prophylactic anticoagulation.
Only a minority of hospitalized oncology patients are appropriate for prophylactic anticoagulation. Where it is suitable, however, it is poorly utilized locally. Local promotion of VTE prophylaxis and further study of this subgroup of hospitalized medical patients may improve uptake of this practice and attenuate morbidity from VTE.
静脉血栓栓塞症（VTE）是肿瘤患者的一个严重问题。在住院的内科患者中，VTE 预防措施的应用不足，但针对肿瘤亚组中其应用的适宜性和频率的数据较少。我们旨在记录当地的实践情况。
在两个规定的 4 周期间，对基督城医院肿瘤服务中心收治的所有住院患者进行了横断面图表回顾。预防性抗凝的适应证和禁忌证的评估基于 2004 年美国胸科医师学会循证共识指南。
在 113 例入肿瘤科的患者中，有 38 例（33.6%）有预防性抗凝的适应证。然而，其中 23 例也有禁忌证，只有 15 例（13%）的患者被认为适合预防性抗凝。只有 1 例患者接受了适当的预防性抗凝治疗。
只有少数住院肿瘤患者适合预防性抗凝。然而，在适合的情况下，它在当地的应用不足。当地推广 VTE 预防措施，并进一步研究住院内科患者这一亚组，可能会提高该实践的应用率，并减轻 VTE 引起的发病率。
