P669Frequency of venous thromboembolic risk evaluation and adequate in-hospital thromboprophylaxis administration

Introduction

The most common in-hospital complication is venous thromboembolism (VTE). High risk patients have an incidence of VTE as higher as 18.3%. Padua and Caprini Scores allow to identify the thromboembolic risk for each type of patients. Thromboprophylaxis administration reduces VTE risk, but as low as 16–33% of medical patients and 25–44% of surgical patients receive this intervention during hospitalization.

Purpose

This study aims to identify basal adherence to evidence-based recommendations for thromboprophylaxis in hospitalized patients (annual evaluation) and its variation following monthly thromboprophylaxis risk evaluation.

Methods

A prospective, descriptive and observational study that included data from annual VTE risk evaluation (Padua/Caprini scores) and thromboprophylaxis administration (from 2015 to july 2018) followed by monthly risk assessments and thromboprophylaxis administration (August to November/2018) in 2.140 medical/surgical hospitalized patients.

Results

A total of 1290 patients (54,15%) had high risk for VTE: 787medical patients (Padua Score) and 503 surgical patients (Caprini score) and therefore they required thromboprophylaxis administration. In total population, adequate thromboprophylaxis administration inceased from 55% (annual evaluation) to 81,4% (monthly evaluation). In medical patients, adequate thromboprophylaxis increased from 59% (Annual evaluation) to 81,3% (monthly evaluation). In surgical patients, adequate thromboprophylaxis increased from 49% during annual evaluation to 81.5% during monthly evaluation (Figure 1).

Figure 1. Correct thromboprophylaxis (2018)

Conclusions

Annual thromboprophylaxis risk evaluation and thromboprophylaxis administration can be improved in medical patients when performed on a monthly basis. This difference does not apply to surgical patients, where monthly evaluations and interventions remains stable. Besides that, more aggressive risk evaluation should be implemented in order to reach thromboprophylaxis administration rates higher than 90%, and this can be done with weekly or daily measurement and intervention.

Acknowledgement/Funding

None

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Anterior cervical myelopathy in the early postoperative period

PURPOSE

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CLINICAL FEATURES

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