Avaliação da profilaxia para tromboembolismo venoso em um Hospital Escola.

Abstract

Venous thromboembolism (VTE) is a frequent and multifactorial entity. It is the leading cause of preventable death in hospital settings, and the adoption of prophylactic strategies is the main tool to combat it. Objective: To assess the rates of prophylactic strategies for VTE use among hospitalized patients at the Hospital Universitário Alcides Carneiro (HUAC), in Campina Grande - PB. In addition, assess the appropriateness of the used methods and verify if there are differences between the medical and surgical patients groups. Methods: We conducted an individuated, cross-sectional, descriptive study, between August and October 2015, involving patients from medical and surgery wards at the HUAC. In each patient, we evaluated the presence of risk factors for VTE, stratifying them into low, medium and high risk. In the following, we evaluated the use of prophylactic strategy as well as its conformity to the Brazilian Society of Angiology and Vascular Surgery (SBACV) recommendations. Data were stored in SPSS, version 21, which used the chi-square test and, when indicated, Fisher's exact test, considering statistically significant p <0.05. Results: We analyzed 117 patients, of whom 61 were from medical (52.1%) and 56 from surgery group (47.9%). After risk stratification for VTE, 22.2% of patients framed in low, 49.6% on average and 28.2% in high-risk, with no statistical difference between clinical and surgical groups. 67.2% of clinical and 69.6% of the surgery patients received some kind of prophylactic strategy. There was no correlation between risk stratum for VTE and utilization of prophylactic strategies (p = 0.77). The adequacy of prophylactic strategy was 37.7% in the clinical group and 32.1% in the surgical, with no statistical difference. Patients at low risk for VTE, however, had higher adequacy of prophylaxis, compared to medium and high risk (p <0.05). Conclusion: VTE prophylaxis is underused in our hospital, and it’s incorrectly used most times, what is consistent with several other national and international studies.