[Evaluation of thromboprophylaxis in patients hospitalized in a tertiary care center: an applicable model of clinical practice evaluation. Revision of 320 cases].

OBJECTIVES: To analyze in-hospital thromboprophylaxis in patients at risk for venous thromboembolism. To evaluate compliance with heparin-induced thrombocytopenia screening recommendations in these patients. PATIENT AND METHODS: We performed a cross-sectional study of 395 patients hospitalized in our tertiary care center at risk for venous thromboembolism. We collected data regarding thromboprophylaxis (risk factors for thrombosis, type of prophylaxis, bleeding risk, demographic data, and hospitalization data).
RESULTS: Three hundred and twenty patients were included in the study; 183 patients were hospitalized on medical wards and 137 patients on surgical wards. Thromboprophylaxis was indicated in 57% of the patients according to the American College of Chest Physicians' clinical practice guidelines. Adequate venous thrombosis prophylaxis was prescribed for 83.7% of these patients (76.1% of medical cases and 90.6% of the surgical cases). In contrast, only 47.1% of at risk patients on the family medicine wards received adequate prophylaxis. 79.3% of patients for whom it was indicated underwent appropriate platelet count monitoring.
CONCLUSION: The use of thromboprophylaxis is well established in our institution. After having reviewed these data we instituted measures to improve our rate of appropriate thromboprophylaxis and platelet count monitoring. This type of evaluation could be considered by other centers in order to evaluate their performance and institute measures to improve their quality of care.