医学
观察研究
肺栓塞
重症监护室
低分子肝素
危险分层
静脉血栓栓塞
急诊医学
肝素
重症监护医学
儿科
血栓形成
外科
内科学
作者
Khalid Ansari,Kuldeep Dalal,Mayur Patel
出处
期刊:Journal of the Indian Medical Association
日期:2007-09-01
卷期号:105 (9): 536, 538, 540 passim-536, 538, 540 passim
被引量:8
摘要
To assess the risk for venous thrombo-embolism (VTE) and the utilisation of VTE prophylaxis in an open medical-surgical intensive care unit (ICU), patients were admitted and enrolled to the ICU at a multispecialty, tertiary care teaching hospital in Mumbai, for an observational study during a 3-month period. Risk factors for VTE and methods of VTE prophylaxis used were noted. Risk stratification was done, and the consultants attending the ICUs filled a questionnaire about VTE awareness, preferences and usage of VTE prophylaxis methods and reasons for not using thromboprophylaxis. Of 580 admissions, 488 were included in the study. As per the risk stratification, thromboprophylaxis was indicated in 466 (95%). The study group had an average VTE risk of 5.74, with a mean risk of 6.48 in medical patients and 5.0 in surgical patients. The most common risk factors in medical patients were bed rest >72 hours (56%), age >60 years (49.6%) and age 40-60 years (38.4%). Among surgical patients, the most common risk factors were major surgery (80.25%), central venous access (59.24%) and age 40-60 years (46.6%). Overall, VTE prophylaxis was used in 229 patients (47%), with 127 (55%) medical and 102 (45%) surgical patients. The most common methods of VTE prophylaxis used were elastic stockings (24.2%), low molecular weight heparin (15%) and low molecular weight heparin and stockings both (9.6%). Fear of bleeding was the commonest reason cited for the underutilisation of VTE prophylaxis. Almost half of all high-risk patients admitted to the ICU didn't receive any thromboprophylaxis. Consistent practice patterns of ICUs, and continuing medical education programmes addressing VTE prophylaxis will help improve the usage of VTE prophylaxis.
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