Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolism
Aim. To reduce the number of preventable hospital-acquired venous thromboembolic events (HA-VTE) and to improve the quality of VTE prophylaxis at multiprofile hospital. Materials and methods. A comprehensive approach to preventing HA-VTE was developed, which involved the global trigger tool method t...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
"Consilium Medicum" Publishing house
2016-09-01
|
| Series: | Терапевтический архив |
| Subjects: | |
| Online Access: | https://ter-arkhiv.ru/0040-3660/article/viewFile/32045/pdf |
| _version_ | 1818408830379229184 |
|---|---|
| author | G I Nazarenko E B Kleymenova S A Payushchik V A Otdelеnov D A Sychev |
| author_facet | G I Nazarenko E B Kleymenova S A Payushchik V A Otdelеnov D A Sychev |
| author_sort | G I Nazarenko |
| collection | DOAJ |
| description | Aim. To reduce the number of preventable hospital-acquired venous thromboembolic events (HA-VTE) and to improve the quality of VTE prophylaxis at multiprofile hospital. Materials and methods. A comprehensive approach to preventing HA-VTE was developed, which involved the global trigger tool method to assess adverse events, as well as the computerized clinical decision support system (CDSS) to prevent HA-VTE on the basis of relevant clinical practice guidelines, and HA-VTE registry. Results. A total of 50 patients (15 men, 35 women; their median age was 70.5 years) with HA-VTE were included in the HA-VTE registry in January 2014 to June 2015. Assessment of a trend in the prevalence of HA-VTE when introducing CDSS to prevent VTE showed its statistically significant decline in the total number of HA-VTE cases (χ2=7.325, df=1; p=0.0068) and in that of HA-VTE in surgical patients (χ2=7.266, df=1; p=0.0070). The statistical significance of χ2 for linear trend was not achieved for medical patients, which is probably due to the small sample size (χ2=2.764, df=1; p=0.0964). While introducing CDSS, there was a statistically significant reduction in the incidence of postoperative VTE from 8.76 to 4.17 cases per 1000 interventions (χ2=5.347, df=1; p=0.0208; the absolute values of HA-VTE and surgical interventions were used for the calculation). Conclusion. The proposed comprehensive approach can substantially increase the detection rate of HA-VTE and decrease its incidence rates. This requires a personified assessment of the risk of VTE and hemorrhage in all hospitalized patients on day 1 of their admission, timely initiation of recommended VTE prophylaxis, and dynamic assessment of the risk of VTE and hemorrhage for timely correction of the prophylaxis. |
| first_indexed | 2024-12-14T09:49:58Z |
| format | Article |
| id | doaj.art-108e9437b8664810ade38d7ca1050b95 |
| institution | Directory Open Access Journal |
| issn | 0040-3660 2309-5342 |
| language | Russian |
| last_indexed | 2024-12-14T09:49:58Z |
| publishDate | 2016-09-01 |
| publisher | "Consilium Medicum" Publishing house |
| record_format | Article |
| series | Терапевтический архив |
| spelling | doaj.art-108e9437b8664810ade38d7ca1050b952022-12-21T23:07:33Zrus"Consilium Medicum" Publishing houseТерапевтический архив0040-36602309-53422016-09-01889233010.17116/terarkh201688923-3029061Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolismG I NazarenkoE B KleymenovaS A PayushchikV A OtdelеnovD A SychevAim. To reduce the number of preventable hospital-acquired venous thromboembolic events (HA-VTE) and to improve the quality of VTE prophylaxis at multiprofile hospital. Materials and methods. A comprehensive approach to preventing HA-VTE was developed, which involved the global trigger tool method to assess adverse events, as well as the computerized clinical decision support system (CDSS) to prevent HA-VTE on the basis of relevant clinical practice guidelines, and HA-VTE registry. Results. A total of 50 patients (15 men, 35 women; their median age was 70.5 years) with HA-VTE were included in the HA-VTE registry in January 2014 to June 2015. Assessment of a trend in the prevalence of HA-VTE when introducing CDSS to prevent VTE showed its statistically significant decline in the total number of HA-VTE cases (χ2=7.325, df=1; p=0.0068) and in that of HA-VTE in surgical patients (χ2=7.266, df=1; p=0.0070). The statistical significance of χ2 for linear trend was not achieved for medical patients, which is probably due to the small sample size (χ2=2.764, df=1; p=0.0964). While introducing CDSS, there was a statistically significant reduction in the incidence of postoperative VTE from 8.76 to 4.17 cases per 1000 interventions (χ2=5.347, df=1; p=0.0208; the absolute values of HA-VTE and surgical interventions were used for the calculation). Conclusion. The proposed comprehensive approach can substantially increase the detection rate of HA-VTE and decrease its incidence rates. This requires a personified assessment of the risk of VTE and hemorrhage in all hospitalized patients on day 1 of their admission, timely initiation of recommended VTE prophylaxis, and dynamic assessment of the risk of VTE and hemorrhage for timely correction of the prophylaxis.https://ter-arkhiv.ru/0040-3660/article/viewFile/32045/pdfdeep vein thrombosispulmonary thromboembolismprophylaxishospital-acquired eventglobal trigger toolclinical decision support system |
| spellingShingle | G I Nazarenko E B Kleymenova S A Payushchik V A Otdelеnov D A Sychev Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolism Терапевтический архив deep vein thrombosis pulmonary thromboembolism prophylaxis hospital-acquired event global trigger tool clinical decision support system |
| title | Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolism |
| title_full | Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolism |
| title_fullStr | Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolism |
| title_full_unstemmed | Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolism |
| title_short | Optimizing the prophylaxis of hospital-acquired deep vein thrombosis and pulmonary thromboembolism |
| title_sort | optimizing the prophylaxis of hospital acquired deep vein thrombosis and pulmonary thromboembolism |
| topic | deep vein thrombosis pulmonary thromboembolism prophylaxis hospital-acquired event global trigger tool clinical decision support system |
| url | https://ter-arkhiv.ru/0040-3660/article/viewFile/32045/pdf |
| work_keys_str_mv | AT ginazarenko optimizingtheprophylaxisofhospitalacquireddeepveinthrombosisandpulmonarythromboembolism AT ebkleymenova optimizingtheprophylaxisofhospitalacquireddeepveinthrombosisandpulmonarythromboembolism AT sapayushchik optimizingtheprophylaxisofhospitalacquireddeepveinthrombosisandpulmonarythromboembolism AT vaotdelenov optimizingtheprophylaxisofhospitalacquireddeepveinthrombosisandpulmonarythromboembolism AT dasychev optimizingtheprophylaxisofhospitalacquireddeepveinthrombosisandpulmonarythromboembolism |