Hospital de Clínicas "Dr Manuel Quintela", Montevideo, Uruguay.
CASMU, Hospital de Clínicas "Dr Manuel Quintela", Montevideo, Uruguay.
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241256368. doi: 10.1177/10760296241256368.
Venous thromboembolism (VTE) is a serious, frequent, and preventable medical complication in hospitalized patients. Although the efficacy of prophylaxis (pharmacological and/or mechanical) has been demonstrated, compliance with prophylaxis is poor at international and national levels.
To determine the indication and use of pharmacological thromboprophylaxis in hospitalized patients in Uruguay.
An observational, descriptive, cross-sectional, multicentre study involving 31 nationwide healthcare facilities was conducted. Baseline characteristics associated with hospital admission, the percentage of the population with an indication for thromboprophylaxis, and the percentage of patients receiving pharmacological thromboprophylaxis were assessed. The VTE risk was determined using the Padua score for medical patients; the Caprini score for surgical patients; the Royal College of Obstetricians and Gynaecologists (RCOG) guidelines for pregnant-postpartum patients.
1925 patients were included, representing 26% of hospitalized patients in Uruguay. 71.9% of all patients were at risk of VTE. Of all patients at risk of VTE, 58.6% received pharmacological thromboprophylaxis. The reasons for not receiving thromboprophylaxis were prescribing omissions in 16.1% of cases, contraindication in 15.9% and 9.4% of patients were already anticoagulated for other reasons. Overall, just 68% of patients were "protected" against VTE. Recommendations of major thromboprophylaxis guidelines were followed in 70.1% of patients at risk.
Despite the progress made in adherence to thromboprophylaxis indications, nonadherence remains a problem, affecting one in six patients at risk of VTE in Uruguay.
静脉血栓栓塞症（VTE）是住院患者中一种严重、常见且可预防的医疗并发症。尽管已证实预防措施（药物和/或机械）的有效性，但国际和国内层面的预防措施依从性都很差。
确定乌拉圭住院患者使用药物性血栓预防的指征和方法。
开展了一项观察性、描述性、横断面、多中心研究，涉及全国 31 家医疗保健机构。评估了与住院相关的基线特征、有血栓预防指征的人群比例以及接受药物性血栓预防的患者比例。对内科患者采用帕多瓦评分（Padua score）、外科患者采用卡普里尼评分（Caprini score）、孕妇/产后患者采用皇家妇产科医师学院（Royal College of Obstetricians and Gynaecologists，RCOG）指南来确定 VTE 风险。
共纳入 1925 例患者，占乌拉圭住院患者的 26%。所有患者中有 71.9%存在 VTE 风险。在所有存在 VTE 风险的患者中，58.6%接受了药物性血栓预防。未接受血栓预防的原因包括：16.1%的病例存在用药遗漏，15.9%存在禁忌证，9.4%的患者因其他原因正在接受抗凝治疗。总体而言，只有 68%的患者可预防 VTE。风险患者中有 70.1%遵循了主要血栓预防指南的建议。
尽管在遵循血栓预防指征方面取得了进展，但仍存在不依从的问题，影响到乌拉圭每 6 名存在 VTE 风险的患者中的 1 名。
