Læknablaðið - 15.06.2012, Síða 22
RANNSÓKN
Heimildir
1. Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist
D, Brecht JG, et al. Venous thromboembolism (VTE) in
Europe. The number of VTE events and associated morbi-
dity and mortality. Thromb Haemost 2007; 98: 756-64.
2. Eurostat statistics on health and safety. epp.eurostat.eu/
portal/page/portal/eurostat/home. desember 2009.
3. Alikhan R, Peters F, Wilmott R, Cohen AT. Fatal pulmon-
ary embolism in hospitalised patients: a necropsy review.
J Clin Pathol 2004; 57:1 254-7.
4. Sandler DA, Martin JF. Autopsy proven pulmonary
embolism in hospital patients: are we detecting enough
deep vein thrombosis? J R Soc Med 1989; 82: 203-5.
5. Prevention of fatal postoperative pulmonary embolism by
low doses of heparin. An international multicentre trial.
Lancet 1975; 2:45-51.
6. Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW,
Patwardhan NA, Jovanovic B, et al. A population-based
perspective of the hospital incidence and case-fatality
rates of deep vein thrombosis and pulmonary embolism.
The Worcester DVT Study. Arch Intern Med 1991; 151:933-
8.
7. Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM,
Lassen MR, et al. Prevention of venous thromboembolism:
American College of Chest Physicians Evidence-Based
Clinical Practice Guidelines (8th Edition). Chest 2008; 133:
381S-453S.
8. Amin A, Stemkowski S, Lin J, Yang G. Thromboprophylaxis
rates in US medical centers: success or failure? J Thromb
Haemost 2007; 5:1610-6.
9. Piazza G, Seddighzadeh A, Goldhaber SZ. Double trouble
for 2,609 hospitalized medical patients who developed
deep vein thrombosis: prophylaxis omitted more often
and pulmonary embolism more frequent. Chest 2007; 132:
554-61.
10. Cohen AT, Tapson VF, Bergmann JF, Goldhaber SZ,
Kakkar AK, Deslandes B, et al. Venous thromboembolism
risk and prophylaxis in the acute hospital care setting
(ENDORSE study): a multinational cross-sectional study.
Lancet 2008; 371:387-94.
11. Gangireddy C, Rectenwald JR, Upchurch GR, Wakefield
TW, Khuri S, Henderson WG, et al. Risk factors and
clinical impact of postoperative symptomatic venous
thromboembolism. J Vasc Surg 2007; 45:335-41; discussion
41-2.
12. Leizorovicz A, Cohen AT, Turpie AGG, Olsson C-G,
Vaitkus PT, Goldhaber SZ, et al. Randomized, Placebo-
Controlled Trial of Dalteparin for the Prevention of
Venous Thromboembolism in Acutely 111 Medical Patients.
Circulation 2004; 110: 874-9.
13. Samama MM, Cohen AT, Darmon JY, Desjardins L, Eldor
A, Janbon C, et al. A comparison of enoxaparin with
placebo for the prevention of venous thromboembolism
in acutely ill medical patients. Prophylaxis in Medical
Patients with Enoxaparin Study Group. N Engl J Med
1999; 341: 793-800.
14. Collins R, Scrimgeour A, Yusuf S, Peto R. Reduction in
Fatal Pulmonary Embolism and Venous Thrombosis by
Perioperative Administration of Subcutaneous Heparin.
N Engl J Med 1988; 318:1162-73.
15. Kakkar AK, Cimminiello C, Goldhaber SZ, Parakh R,
Wang C, Bergmann J-F. Low-Molecular-Weight Heparin
and Mortality in Acutely 111 Medical Patients. N Engl J
Med 2011; 365: 2463-72.
16. Prandoni P, Lensing AW, Cogo A, Cuppini S, Villalta S,
Carta M, et al. The long-term clinical course of acute deep
venous thrombosis. Ann Intem Med 1996; 125:1 -7.
17. Karlsson G, Riba P, Thoroddsson I, Gudbjomsson B.
Segamyndun í djúpum bláæðum ganglima. Uppgjör frá
FSA 1975-1990. Læknablaðið 2000; 86:19-24.
18. Sjálander A, Jansson JH, Bergqvist D, Eriksson H, Carlberg
B, Svensson P. Efficacy and safety of anticoagulant
prophylaxis to prevent venous thromboembolism in
acutely ill medical inpatients: a meta-analysis. J Int Med
2008; 263: 52-60.
19. Maynard G, Stein J. Designing and implementing effective
venous thromboembolism prevention protocols: lessons
from collaborative efforts. J Thromb Thrombolys 2010; 29:
159-66.
20. Preventing Hospital-Acquired Venous Thromboembolism
A Guide for Effective Quality Improvement. Society
of Hospital medicine. hospitalmedicine.org/AM/
Template.cfm?Section=Quality_Improvement_Resource_
Rooms&Template=/CM/ContentDisplay.cfm&Conten-
tID=6092. - ágúst 2010.
21. Bullock-Palmer RP, Weiss S, Hyman C. Innovative app-
roaches to increase deep vein thrombosis prophylaxis
rate resulting in a decrease in hospital-acquired deep vein
thrombosis at a tertiary-care teaching hospital. J Hosp
Med 2008; 3:148-55.
ENGLISH SUMMARY
Evaluation of thromboprophylactic therapy at Landspítali - The National
University Hospital of lceland; a cross-sectional study on acute wards
Kristjánsdottir HL1, Gudnadottir GS', Fjalldal SB', Thorarinsdottir HR2, Bjarnason A', Einarsson O'
Objective: Venous thromboembolic disease is a serious and often fatal
complication following hospital admission. Studies show that thrombop-
rophylactic therapy for this condition is often underutilized. The aim of
this study was to evaluate the performance of thromboprophylactic the-
rapy at Landspítali - The University Hospital of lceland in adult patients
admitted to acute wards.
Methods and materials: On 2 December 2009 hospital charts of
admitted patients on acute wards were reviewed and assessed for app-
ropriatethromboprophylactic treatment according to the 2008 guidelines
from The American College of Chest Physicians. The results were
compared to those of other countries from the multinational Endorse
study from 2008.
Results: 251. patient were included of whom 47% were considered at
risk for venous thromboembolic disease. Of those 57% received app-
ropriate thromboprophylactic treatment or 78% of surgical and 26% of
medical patients.
Conclusions: Adherence to clinical guidelines for thromboprophylactic
treatment at surgical wards of Landspítali - The National University
Hospital of lceland was good and well above the average compared to
the results of the Endorse study. Performance on the medical wards
was on the other hand below average. Our results show that application
of thromoboprophylactic treatment at Landspítali could be improved
and thereby enhance patient safety.
Key words: prophylactic treatment, venous thromboembolism, hospitalized patients.
Correspondence: Hallgerður Lind Kristjánsdóttir hallgerdur.lind@gmail.com
Departments of ’Medicine and 2Anasthesia and Intensive Care, Landspítali-University Hospital.
346 LÆKNAblaðið 2012/98