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Underutilization of venous thromboemoblism prophylaxis in medical patients in a tertiary care center

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Abstract

Background New recommendations concerning the use of prophylactic anticoagulation for medically ill patients have been in use for some time now. This study aims at assessing how much house-staff in a tertiary care setting are implementing these new recommendations in the hope that through quantitative analysis of the deficiency we would be able to identify areas of weakness. Methods About 250 patients were randomly selected from all patients admitted to the American University of Beirut Medical Center (AUBMC) during the year 2005 and stayed more than 48 h. The risk factor profiles, contraindications to thromboprophylaxis, if present, and whether these patients received the appropriate VTE pharmacologic prophylaxis during their stay in hospital were recorded. Results About 139 patients were found to have two or more risk factors, with no absolute contraindications. About 37 patients (26.6%) received VTE prophylaxis. Upon reviewing the risk factors profile, the majority of patients (71.3%) were found to have 2–4 risk factors. Among risk factors studied, age > 40 years, admission to ICU, prior VTE, chronic lung disease, infection, respiratory failure, and central venous catheter were significantly associated with receiving prophylaxis. Conclusions VTE prophylaxis is underutilized at AUBMC, a tertiary care teaching hospital in the Middle East. Critical care patients were being acceptably anti-coagulated, whereas cancer patients are doing the worst.

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Authors and Affiliations

  1. Department of Internal Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon

    Ramy Masroujeh, Wael Shamseddeen, Hussain Isma’eel, Zaher K. Otrock & Ali Taher

  2. Department of Surgery, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon

    Ismail M. Khalil

Authors
  1. Ramy Masroujeh
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  2. Wael Shamseddeen
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  3. Hussain Isma’eel
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  4. Zaher K. Otrock
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  5. Ismail M. Khalil
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  6. Ali Taher
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Correspondence to Ali Taher.

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Ramy Masroujeh and Wael Shamseddeen are equally contributed in this article.

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Masroujeh, R., Shamseddeen, W., Isma’eel, H. et al. Underutilization of venous thromboemoblism prophylaxis in medical patients in a tertiary care center. J Thromb Thrombolysis 26, 138–141 (2008). https://doi.org/10.1007/s11239-007-0084-y

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  • DOI: https://doi.org/10.1007/s11239-007-0084-y

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