Pharmacy, Hospital Universitario Fundacion Alcorcon, Alcorcon, Spain
Pharmacy, Hospital Universitario Fundacion Alcorcon, Alcorcon, Spain.
Eur J Hosp Pharm. 2023 Sep;30(5):264-267. doi: 10.1136/ejhpharm-2021-002877. Epub 2021 Oct 14.
Antithrombotic prophylaxis in hospitalised patients with SARS-CoV-2 acute infection has increased. Currently, most of the evidence relates to patients in intensive care units; however, there is little information on patients admitted to hospital wards and there is no consensus protocol on thromboprophylaxis during admission and after discharge.
To assess the effectiveness of antithrombotic prophylaxis in patients admitted with COVID-19 and 30 days after discharge.
A prospective observational study was conducted of patients admitted with COVID-19 in which the hospital thromboprophylaxis protocol was applied, classifying the patients as having a standard or high risk of thrombosis. Pharmacists performed a daily follow-up and actively intervened during admission and at discharge. The main outcome measure was the global incidence of symptomatic venous thromboembolism (VTE) related to hospitalisation.
A total of 113 patients were included, 98.23% of whom were admitted to a hospital ward. The incidence of hospital-acquired VTE was 1.77%. In 75.22% of the subjects, thromboprophylaxis was adjusted to the protocol during admission. A total of 23 pharmaceutical interventions were conducted, with an adherence of 52.17%. At discharge, 94.28% of the patients who had no haemorrhage and ≥4 points on the Padua Prediction Score required thromboprophylaxis, aligning with the protocol. The global incidence of haemorrhagic events during the follow-up period was 0.88%.
The incidence of hospital-acquired VTE was lower than that described in the literature. Although it cannot be certain that it is directly related to the instituted protocol, the data can show that the management of prevention of VTE is being optimally performed at the hospital. Long-term studies are needed to evaluate the incidence after discharge, as well as to agree on a specific protocol in the COVID-19 population for the prevention of these events during hospitalisation and post-discharge.
患有 SARS-CoV-2 急性感染的住院患者的抗血栓预防措施有所增加。目前，大多数证据都与重症监护病房的患者有关；然而，关于住院病房患者的信息很少，并且在住院期间和出院后没有关于抗血栓预防的共识方案。
评估 COVID-19 住院患者和出院后 30 天的抗血栓预防效果。
对应用医院血栓预防方案的 COVID-19 住院患者进行前瞻性观察性研究，将患者分为具有标准或高血栓形成风险。药剂师进行日常随访，并在住院期间和出院时积极干预。主要结局指标是与住院相关的有症状静脉血栓栓塞症（VTE）的全球发生率。
共纳入 113 例患者，其中 98.23%的患者住院于病房。医院获得性 VTE 的发生率为 1.77%。在 75.22%的患者中，在住院期间调整了预防血栓的方案。共进行了 23 次药物干预，依从性为 52.17%。出院时，94.28%的无出血且 Padua 预测评分≥4 分的患者需要进行抗血栓预防，符合方案。在随访期间，出血事件的全球发生率为 0.88%。
医院获得性 VTE 的发生率低于文献中描述的发生率。尽管不能确定这是否直接与制定的方案有关，但数据可以表明，医院在预防 VTE 方面的管理得到了最佳执行。需要进行长期研究来评估出院后的发生率，并在 COVID-19 人群中达成预防这些事件的特定方案，包括住院期间和出院后的预防方案。
