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Intensive Care Medicine

, Volume 40, Issue 11, pp 1698–1708 | Cite as

PROF-ETEV study: prophylaxis of venous thromboembolic disease in critical care units in Spain

  • Pablo García-OlivaresEmail author
  • Jose Eugenio Guerrero
  • Pedro Galdos
  • Demetrio Carriedo
  • Francisco Murillo
  • Antonio Rivera
Original

Abstract

Purpose

Venous thromboembolic disease (VTE) in critically ill patients has a high incidence despite prophylactic measures. This fact could be related to an inappropriate use of these measures due to the absence of specific VTE risk scores. To assess the current situation in Spain, we have performed a cross-sectional study, analyzing if the prophylactic measures were appropriate to the patients’ VTE risk.

Methods

Through an electronic questionnaire, we carried out a single day point prevalence study on the VTE prophylactic measures used in several critical care units in Spain. We performed a risk stratification for VTE in three groups: low, moderate–high, and very high risk. The American College of Chest Physicians guidelines were used to determine if the patients were receiving the recommended prophylaxis.

Results

A total of 777 patients were included; 62 % medical, 30 % surgical, and 7 % major trauma patients. The median number of the risk factors for VTE was four. According to the proposed VTE risk score, only 2 % of the patients were at low risk, whereas 83 % were at very high risk. Sixty-three percent of patients received pharmacological prophylaxis, 12 % mechanical prophylaxis, 6 % combined prophylaxis, and 19 % did not receive any prophylactic measure. According to criteria suggested by the guidelines, 23 % of medical, 71 % of surgical, and 70 % of major trauma patients received an inappropriate prophylaxis.

Conclusions

Most critically ill patients are at high or very high risk of VTE, but there is a low rate of appropriate prophylaxis. The efforts to improve the identification of patients at risk, and the implementation of appropriate prevention protocols should be enhanced.

Keywords

Venous thromboembolic disease Critically ill patients Antithrombotic therapy Critical care unit 

Notes

Conflicts of interest

Pablo Garcia Olivares and Jose Eugenio Guerrero Sanz have participated in several symposiums about venous thromboembolic disease in critically ill patients, organized by Covidien Spain S.L.

Supplementary material

134_2014_3442_MOESM1_ESM.doc (43 kb)
Supplementary material 1 (DOC 43 kb)
134_2014_3442_MOESM2_ESM.doc (56 kb)
Supplementary material 2 (DOC 56 kb)
134_2014_3442_MOESM3_ESM.doc (80 kb)
Supplementary material 3 (DOC 80 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2014

Authors and Affiliations

  • Pablo García-Olivares
    • 1
    Email author
  • Jose Eugenio Guerrero
    • 2
  • Pedro Galdos
    • 3
  • Demetrio Carriedo
    • 4
  • Francisco Murillo
    • 5
  • Antonio Rivera
    • 6
  1. 1.Intensive Care UnitGregorio Marañón Universitary HospitalMadridSpain
  2. 2.Intensive Care UnitGregorio Marañón Universitary Hospital and HM Hospitals GroupMadridSpain
  3. 3.Intensive Care UnitPuerta de Hierro Universitary HospitalMadridSpain
  4. 4.Intensive Care UnitLeón Universitary HospitalLeónSpain
  5. 5.Intensive Care UnitVirgen del Rocio Universitary HospitalSevilleSpain
  6. 6.Intensive Care UnitSan Agustin HospitalAsturiasSpain

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