Objective: Venous thromboembolic disease  is a serious and often fatal complication following hospital admission. Studies show that thromboprophylactic therapy for  this condition is often underutilized. The aim of this study was to evaluate the performance of thromboprophylactic therapy at Landspítali - The University Hospital of Iceland in adult patients admitted to acute wards.

Methods and materials: On 2 December 2009 hospital charts of admitted patients on acute wards were reviewed and assessed for appropriatethromboprophylactic treatment according to the 2008 guidelines from The American College of Chest Physicians. The results were compared to those of other countries from the multinational Endorse study from 2008.

Results:  251 patient were included of whom 47% were considered at risk for venous thromboembolic disease. Of those 57% received appropriate thromboprophylactic treatment or 78% of surgical and 26% of medical patients.

Conclusions: Adherence to clinical guidelines for thromboprophylactic treatment at surgical wards of Landspítali - The  National University Hospital of Iceland was good and well above the average compared to the results of  the Endorse study. Performance on the medical wards was on the other hand below average. Our results show that application of thromoboprophylactic treatment at Landspítali could be improved and thereby enhance patient safety.

Kristjánsdottir HL¹, Gudnadottir GS¹, Fjalldal SB¹, Thorarinsdottir HR², Bjarnason A¹, Einarsson O¹

Departments of ¹Medicine and ²Anasthesia and Intensive Care, Landspítali-University Hospital.

Figure 1: Selection of study population and reasons for exclusions.

Figure 2:
A) Proportion of patients at risk for venous thromboembolism at Landspitali University Hospital compared to the results of the Endorse study for various countries.¹⁰

B)  Proportion of at-risk patients receiving recommended prophylaxis at Landspitali University Hospital compared to the results of the Endorse study for various countries.¹⁰

Figure 3:
A)    Proportion of at risk patients at medical wards who received thromboprophylactic therapy according to the ACCP leiðbeiningarnar.⁷

B)    Proportion of at risk patients at surgical wards who received thromboprophylactic therapy according to the ACCP leiðbeiningarnar.⁷

 

Table I: Comparison of the demographics of assessable patients depending on whether they should or should not be receiving thromboprophylactic treatment. Data is displayed as the number of patients and percentage unless otherwise stated.

Table II: Resons for hospital admission to the wards of Landspitali for patients with and without indications for thromboprophylactic treatment.

Table III: Indications for prophylactic treatment against venous thromboembolism in patients receiving prophylactic treatment and in patients missing prophylactic treatment.