Thromboprophylaxis practice in teaching hospital settings

Venous thromboembolism (VTE) is known to be a major cause of morbidity and mortality among hospitalized
patients. The American College of Chest Physicians (ACCP) published their seventh ACCP Conference on Antithrombotic
and Thrombolytic Therapy in 2004, with recommendations for venous thromboembolism prophylaxis. Despite these
recommendations, appropriate thrompoprophylaxis is underused.
This study was performed to examine the frequency and adequacy of thromboprophylaxis in hospitalized patients in three
primary-tertiary teaching hospitals in Urmia, Iran.
Materials and Methods: We carried out a cross-sectional prospective study on 436 patients hospitalized in three teaching
hospitals in Urmia, Iran. Information was obtained from medical-nursing records and patient observation and was compared
with the recommended guidelines of the ACCP. The appropriateness of diagnoses was not evaluated.
Results: Of 436 patients, 352 subjects required thromboprophylaxis and the total proportion of them who underwent some
form of thromboprophylaxis was 16.7% with only 9.9% receiving ACCP recommended prophylaxis. Prophylaxis rate was:
29.7% in medical wards, 27.8% in ICU, 11.0% in surgical wards overall and14.7% postoperatively. Low dose heparin was the
most common type of prophylaxis.
Conclusion: Despite the widely disseminated, evidence-based recommendations, venous thromboembolism prophylaxis is
underused in our hospitals. It is more commonly neglected in our hospitals than those in Western countries. We think that in
most other developing countries, this condition is similar. Therefore, the consensus statements alone are insufficient to
ensure the routine use of prophylactic strategies in clinical practice. In addition to the statements, other strategies are
required to solve the problem