Nieto Rodríguez José Antonio
Servicio de Medicina Interna, Hospital Virgen de la Luz, Cuenca, España.
Med Clin (Barc). 2009 Jun 6;133(1):1-7. doi: 10.1016/j.medcli.2009.01.040. Epub 2009 May 15.
The proportion of patients at risk of venous thromboembolism (VTE) in Spanish hospitals and, among those, the proportion who receive prophylaxis are not well known. The objective of this study was to obtain this information by means of the analysis of data from the Spanish centres that participated in the international ENDORSE study.
Cross-sectional study in 20 Spanish hospitals. VTE risk factors and VTE prophylaxis were assessed in all hospital inpatients, aged 18 years or over, admitted to a surgical ward, and 40 years or over admitted to a medical ward. The 7th Conference of the American College of Chest Physicians (ACCP) guidelines and recommendations were used as a reference to assess risk categories and the prophylaxis given to patients.
6.554 hospital beds were assessed, and 3.809 inpatients were enrolled; 2.069 (67,5%) were medical and 996 (32,5%) surgical. Based on the ACCP criteria, 1.878 (61,3%) were at risk for VTE, 1.140 (55,1%) were medical and 738 (74,1%) were surgical. According to the ACCP guidelines and recommendations, 731 medical patients at risk of VTE (64,1%, 95% CI 61,3%-66,9%) received appropriate prophylaxis, as compared to 605 (82%; 95% CI 79,2%-84,8%) surgical patients (p<0,001).
VTE prophylaxis in the Spanish centres was more common in surgical patients than in medical patients. Nevertheless, it is still necessary to extend the VTE prophylaxis to a significant number of patients (29%) at high risk of VTE, particularly in medical wards.
西班牙医院中存在静脉血栓栓塞症（VTE）风险的患者比例，以及其中接受预防治疗的患者比例尚不清楚。本研究的目的是通过分析参与国际ENDORSE研究的西班牙中心的数据来获取这些信息。
对20家西班牙医院进行横断面研究。对所有入住外科病房且年龄在18岁及以上、入住内科病房且年龄在40岁及以上的住院患者评估VTE风险因素和VTE预防措施。以美国胸科医师学会（ACCP）第七届会议的指南和建议为参考来评估风险类别及给予患者的预防措施。
评估了6554张医院床位，纳入3809例住院患者；2069例（67.5%）为内科患者，996例（32.5%）为外科患者。根据ACCP标准，1878例（61.3%）有VTE风险，1140例（55.1%）为内科患者，738例（74.1%）为外科患者。根据ACCP指南和建议，731例有VTE风险的内科患者（64.1%，95%CI 61.3%- 66.9%）接受了适当的预防治疗，相比之下，605例（82%；95%CI 79.2%-84.8%）外科患者接受了适当的预防治疗（p<0.001）。
西班牙各中心的VTE预防措施在外科患者中比在内科患者中更常见。然而，仍有必要将VTE预防措施扩展至大量有VTE高风险的患者（29%），尤其是在内科病房。
