1. Chu, Julie MSN
  2. Cutugno, Christine PhD, RN

Article Content

According to this article:


* Over half of hospitalized patients are at risk for venous thromboembolism, but only half of those get adequate prophylaxis.


* Venous thromboembolism is the largest cause of preventable in-hospital deaths.



Venous thromboembolism causes 5% to 10% of in-hospital deaths and is the "most common preventable cause." Evidence-based consensus treatment guidelines, available for 15 years, are widely underused.


The ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting) study evaluated 68,183 patients in 358 hospitals and 32 countries between August 2006 and January 2007. Using the 2004 evidence-based consensus criteria and guidelines from the American College of Chest Physicians, the researchers found that 64.4% of surgical patients and 41.5% of medical patients were at risk for venous thromboembolism. Only 58.5% of surgical patients and 39.5% of medical patients received recommended prophylaxis. The prevalence of prophylaxis for patients at risk ranged from less than 2% to 84%, varying by country. Acceptable prophylaxis can be mechanical (compression devices) or pharmacologic(anticoagulation or antiplatelet agents).


Risks were classified into preexisting and postadmission risks. The most common preexisting risk factors were chronic pulmonary disease and chronic heart failure (in medical patients) and obesity (in surgical patients). The most common postadmission risk factors in both medical and surgical patients were complete im-mobilization, immobility with bathroom privileges, and admission to a critical care unit or ICU.-CC


Cohen AT, et al. Lancet 2008;371(9610): 387-94.