1 research outputs found
Thromboprophylaxis in the hospitalized medical patient by internal medicine : a cross-sectional study
Introducci贸n: el tromboembolismo venoso es una de las principales causas de morbimortalidad prevenible seguida de una hospitalizaci贸n. Las heparinas han demostrado ser eficaces para su
prevenci贸n, sin embargo se ha documentado la subutilizaci贸n de estos f谩rmacos, por lo que implementar medidas que garanticen la formulaci贸n adecuada es fundamental. En nuestra instituci贸n se
han instaurado estrategias para mejorar la formulaci贸n de estos f谩rmacos con resultados iniciales
favorables, pero se desconoce el efecto a m谩s largo plazo.
M茅todos: estudio descriptivo, retrospectivo de corte transversal. Se evaluaron pacientes mayores de 18 a帽os, hospitalizados por medicina interna entre junio y noviembre de 2012. Se estim贸
una muestra representativa de 102 pacientes. Se identific贸 la formulaci贸n de la tromboprofilaxis al
segundo d铆a de hospitalizaci贸n, se determin贸 si fue adecuada seg煤n las gu铆as institucionales y los
errores en la prescripci贸n de la misma. Se compararon los resultados con dos mediciones previas
realizadas en la instituci贸n.
Resultados: de los 102 pacientes evaluados, la tromboprofilaxis fue adecuada en 63 (61,8%) e
inadecuada en 39 (38.2%). Las causas m谩s frecuentes de error fueron: formulaci贸n en pacientes de
bajo riesgo 18 (46.1%) y error por omisi贸n en 12 (30.7%) pacientes. La formulaci贸n en pacientes
con indicaci贸n y sin contraindicaci贸n disminuy贸 de 92-82% y en pacientes sin indicaci贸n aument贸 de
50-56.2%, con relaci贸n a una medida previa realizada despu茅s de la difusi贸n de gu铆as institucionales.
Conclusiones: la tromboprofilaxis en pacientes hospitalizados por medicina interna en nuestra
instituci贸n se ordena en un alto porcentaje, sin embargo debe ser mejorada. El principal error es
la formulaci贸n en pacientes con riesgo bajo. La implementaci贸n de estrategias para mejorar la
tromboprofilaxis logr贸 una mejor铆a inicial, pero tiende a disminuir con el tiempo. Se requiere un
trabajo continuado de m煤ltiples medidas que garanticen su impacto favorable a largo plazo.Introduction: venous thromboembolism is one of the major causes of preventable morbidity
and mortality following a hospitalization. Heparins have proven effective for prevention; however,
underutilization of these drugs has been documented, so that the implementation of measures to ensure
the proper formulation is essential. Strategies to improve the formulation of these drugs have been
established in our institution with favorable initial results, but the longer-term effect is unknown.
Methods: descriptive, retrospective cross-sectional study. Patients over 18 years hospitalized
for internal medicine between June and November 2012 were evaluated. A representative sample
of 102 patients was estimated. Thromboprophylaxis formulation was identified on the second day
of hospitalization and it was determined if its prescription was appropriate in accordance with theinstitutional guidelines as well as errors in its prescription. The results were compared with two
previous measurements realized in the institution.
Results: Of the 102 patients evaluated, thromboprophylaxis was adequate in 63 (61.8%) and
inadequate in 39 (38.2%). The most frequent causes of error were: prescription in low-risk patients
18 (46.1%) and error of omission in 12 (30.7%) patients. The formulation in patients with an indication and without contraindication decreased from 92% to 82% and in patients with no indication
increased from 50% to 56.2%, compared to a previous measurement made after the dissemination
of institutional guidelines.
Conclusions: thromboprophylaxis in hospitalized patients in internal medicine at our institution is organized in a high percentage, but must be improved. The main error is the formulation in
patients with low risk. The implementation of strategies to improve thromboprophylaxis achieved
initial improvement, but tends to decrease over time. Continued work of multiple measures to ensure
their favorable long-term impact is required