Risk-assessment algorithm and recommendations for venous thromboembolism prophylaxis in medical patients

Risk-assessment algorithm and recommendations for venous thromboembolism prophylaxis in medical patients

The risk for venous thromboembolism (VTE) in medical patients is high, but risk assessment is rarely performed because there is not yet a good method to identify candidates for prophylaxis. To perform a systematic review about VTE risk factors (RFs) in hospitalized medical patients and generate reco...

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Bibliographic Details
Published in:Vascular health and risk management Vol. 3; no. 4; pp. 533 - 553
Main Authors: Rocha, Ana T, Paiva, Edison F, Lichtenstein, Arnaldo, Milani, Jr, Rodolfo, Cavalheiro, Cyrillo Filho, Maffei, Francisco H
Format: Journal Article
Language:English
Published: New Zealand Taylor & Francis Ltd 2007
Dove Medical Press
Subjects:
Algorithms
Anticoagulants
Hospitalization
Humans
Risk Assessment
Systematic Review
Thromboembolism
Thromboembolism - prevention & control
Canada, Alberta, Cochrane
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Summary:The risk for venous thromboembolism (VTE) in medical patients is high, but risk assessment is rarely performed because there is not yet a good method to identify candidates for prophylaxis. To perform a systematic review about VTE risk factors (RFs) in hospitalized medical patients and generate recommendations (RECs) for prophylaxis that can be implemented into practice. A multidisciplinary group of experts from 12 Brazilian Medical Societies searched MEDLINE, Cochrane, and LILACS. Two experts independently classified the evidence for each RF by its scientific quality in a standardized manner. A risk-assessment algorithm was created based on the results of the review. Several VTE RFs have enough evidence to support RECs for prophylaxis in hospitalized medical patients (eg, increasing age, heart failure, and stroke). Other factors are considered adjuncts of risk (eg, varices, obesity, and infections). According to the algorithm, hospitalized medical patients > or =40 years-old with decreased mobility, and > or =1 RFs should receive chemoprophylaxis with heparin, provided they don't have contraindications. High prophylactic doses of unfractionated heparin or low-molecular-weight-heparin must be administered and maintained for 6-14 days. A multidisciplinary group generated evidence-based RECs and an easy-to-use algorithm to facilitate VTE prophylaxis in medical patients.
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ISSN:1176-6344
1178-2048
1178-2048