Physicians' practice for prevention of venous thromboembolism in medical patients.

OBJECTIVE: To audit physicians' practice of providing prophylaxis for venous thromboembolism (VTE) in patients admitted to acute- care medical wards and to determine the consequences of lack of prophylaxis.

DESIGN: Case-control comparative study.

PLACE AND DURATION OF STUDY: All patients admitted to medical service of Riyadh Medical Complex (RMC) who stayed longer than six days were studied between July 2001 and 2002.

PATIENTS AND METHODS: Demographic data as well as risk factors for VTE were identified for all patients who were divided in two groups. Patients who received prophylaxis (group-A) and those who did not (group-B) were both followed up. Type of prophylaxis and any complications were documented. Duplex ultrasound of the lower limbs was done in all patients in both groups and the outcome for all patients were documented.

RESULTS: Two hundred and forty-nine (249) patients were studied. Ninety-eight (39.35%) patients (group-A) received prophylaxis for VTE, while 151 (60.65%) patients (group-B) did not receive prophylaxis. Twenty-five point eight percent (25.8%), 37.5%, and 50% of patients with 3, 4 and 5 risk factors respectively did not receive thromboprophylaxis. Duplex sonography did not reveal deep venous thrombosis (DVT) in any patient of the two groups in hospital and upto one month after discharge. There was no statistical difference in mortality between the two groups.

CONCLUSION: Physicians' practice showed low threshold for providing VTE prophylaxis for medical patients. This was not translated to higher incidence of VTE or higher hospital mortality.