Venous thromboembolism risk and prophylaxis in a Saudi hospital.

OBJECTIVES: To evaluate the risk factors and physician's compliance to American College of Chest Physicians (ACCP) guidelines recommendations for venous thromboembolism (VTE) prevention at our hospital.

METHODS: This retrospective cohort study was conducted at King Abdulaziz Hospital, Al-Ahsa, Saudi Arabia from November 2009 to December 2009. We used the American College of Chest Physicians (ACCP) 2008 guidelines and Caprini's scores to assess VTE risk and to determine whether patients had received recommended prophylaxis. All hospital in-patients aged 15 years or above were assessed for risk of VTE by reviewing the hospital chart. A data sheet was developed to obtain the data on demographics, VTE prophylaxis medication, dose, route, duration, and associated risk factors. The primary endpoint was the rate of appropriate thromboprophylaxis.

RESULTS: Nine hundred and sixty-eight patients were included. The mean age was 40 ± 18.7 years, and 647 (66.8%) were women. According to the ACCP criteria, 547 (56.5%) patients were at risk for VTE. Of 210 patients that qualified for prophylaxis, 117 (55.7%) received some form of prophylaxis. However, 46 (39.3%) of them received ACCP-recommended VTE prophylaxis. In contrast, 25.6% of patients with no risk, according to Caprini score, had thromboprophylaxis prescribed.

CONCLUSIONS: This study demonstrates that only a small proportion of eligible patients received the recommended VTE prophylaxis. Efforts should be made to develop strategies to improve patient safety practices.