Hacettepe Üniversitesi Tıp Fakültesi Erişkin Hastanesi Cerrahi ve Dahili Servislerinde Yatan Hastalarda Derin Ven Trombozu Profilaksisinin Uygun Kullanımının Kesitsel Değerlendirmesi

Abstract

Venous thromboembolism is a world-wide preventable disease which has high mortality and morbidity. Beside the importance of the diagnosis and treatment of venous thromboembolism, prevention in high-risk group is also important for mortality-morbidity reduction and cost effectivity. The main aim of this study was to evaluate the proper use of deep venous thrombosis prophylaxis in patients hospitalized in internal medicine and surgical wards of Hacettepe University Adult Hospital. The second aim was to recommend a quality improvement process in our hospital. Two hundred twenty three patients over 18 years, hospitalized in Hacettepe University Medical Faculty Hospital internal medicine and surgical wards, were enrolled in June 2013 in a cross-sectional screening. Prophylaxis indications were assigned according to the 2012 guideline of American College of Chest Physicians (ACCP) Antithrombotic Therapy and Prevention of Thrombosis. Patients’ demographical characteristics such as age, gender, and also reasons for hospitalization, co-morbidities, medical treatments and laboratory values were recorded. With regard to these indications, the appropriateness of the prophylactic therapy, either pharmocalogical or mechanical, was evaluated. Twenty patients who had indication of anticoagulant therapy at therapeutic doses were excluded from the study. Only 29 of 130 patients (22%) who had indication of prophlaxis were receiving appropriate prophylaxis in terms of method and/or dosage. On the other hand, 7 out of 73 (10%) patients were receiving prophylaxis although not indicated clinically. As a result in our hospital, prophylaxis of deep venous thromboembolism has a great variation and according to recent guidelines, low compliance ratios were detected.