0
Abstract: Poster Presentations |

ASSESMENT OF ADEQUACY OF DEEP VENOUS THROMBOSIS (DVT) PROPHYLAXIS IN PATIENTS WITH HOSPITAL-AQUIRED DVT IN A COMMUNITY TEACHING HOSPITAL FREE TO VIEW

Aron Rubin, MD; William Dinan, MD, FCCP; Ari Klapholz, MD, FCCP; Edgardo Soto, MD*
Author and Funding Information

Cabrini Medical Center, New York, NY



Chest. 2006;130(4_MeetingAbstracts):259S. doi:10.1378/chest.130.4.937
Text Size: A A A
Published online

Abstract

PURPOSE: Deep venous thrombosis(DVT) is common/preventable medical condition contributing to increased morbidity/mortality/length of stay(LOS)/cost/pulmonary embolus(PE). The purpose of our study was to evaluate adequate prophylaxis [our definition of adequate DVT prophylaxis was based on the Seventh ACCP Conference(SACCPC) Guidelines on Antithrombotic and Thrombolytic Therapy] and activity order in hospitalized patients with hospital acquired DVT in a community teaching hospital.

METHODS: Retrospective chart review of hospitalized patients from January 2004 to September 2005 who developed DVT while in the hospital. Analysis included demographics, admitting service/unit, activity order, type of DVT prophylaxis used, hospital day when the diagnosis of DVT was made, location of DVT, LOS, development of PE and clinical outcomes.

RESULTS: 72 patients were identified including 46(64%) females and 26(36%) males. 37(51%) of patients were medical, 20(28%) surgical and 15(21%) orthopedic. 52(72%) patients were on medical/ surgical units and 20(28%) were in ICU/CCU. 14/72(19%) patients had no activity order, 25(35%) had bed rest order, 14(19%) as tolerated order and 19(27%) out of bed order(OOB).There was no DVT prophylaxis in 19/37(51%) medical, 6/20(30%) surgical and 3/15(20%) orthopedic patients. There was inadequate prophylaxis in 6/37(16%)medical, 7/20(35%) surgical and 5/15(33%) orthopedic patients. 59/72(82%) patients developed lower extremity DVT and 13/72(18%) upper extremity DVT. The DVTs occured on average on hospital day 15. 9(13%) patients were diagnosed with PE (2 medical, 5 surgical and 2 orthopedic). 6(8%) patients expired and none from PE.

CONCLUSION: 53(73%) of all the patients had no activity order, bed rest order, or as tolerated order(this is vague order). 46(64%)had either no or inadequate DVT prophylaxis. These DVTs most likely contributed to increased LOS and definitely contributed to an increase in morbidity in hospitalized patients.

CLINICAL IMPLICATIONS: All patients should be screened for DVT prophylaxis on admission and regularly during hospitalization. All patients should have OOB orders whenever possible. Mandatory admission forms that include patient activity orders and screening for DVT prophylaxis should implemented in all hospitals. DVT prophylaxis should be consistent with SACCPC guidelines.

DISCLOSURE: Edgardo Soto, None.

Wednesday, October 25, 2006

12:30 PM - 2:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543