A clinical audit on venous thromboembolism prophylaxis of medical patients in West Medical Ward, Mayo Hospital

Abstract

Objective: To reduce risk of Deep Venous Thrombosis/ Pulmonary Embolism in an acutely ill hospitalized medical patient and the consequent clinical complications. Place and duration: The study was carried out in the West Medical Unit of Mayo Hospital, Lahore from January, 2005 to May, 2005. Subjects and methods: A total of 100 cases were selected from the patients hospitalized in the ward on the basis of presence of risk factors with no contraindications to heparin prophylaxis, taking into account the age, gender, final diagnosis of the patient, the existing risk factors, the risk stratification, the exclusion criteria, whether heparin prophylaxis was given or not, if given type of heparin administered, and whether patients receiving prophylaxis were monitored or not using Platelet Count, APTT or other monitoring techniques. Results: 19 cases were under Moderate Risk of developing Venous Thromboembolism (VTE) and 81 cases were under High Risk. 7 received Heparin prophylaxis. 3 of them were at Moderate Ri sk and 4 cases at High Risk of developing VTE. Conclusion: All acutely ill medical adult patients admitted should be adequately assessed and screened for presence of Risk Factors and categorized according to the SAVE Risk Stratification. In the absence of Exclusion factors, all cases of High Risk and Moderate Risk should be started on Heparin Prophylaxis as early as possible in hospital admission. The audit should be repeated for re-evaluation after adequate time.