PA-driven VTE risk assessment improves compliance with recommended prophylaxis

摘要

Venous thromboembolism (VTE), which includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), affects 900,000 Americans annually and is a major cause of morbidity and mortality in hospitalized patients. In particular, a postoperative patient is at high risk for venous stasis, vascular endothelial injury, and a hypercoagulable state, each of which is predisposing to DVT. The most severe complication of DVT is PE, which occurs in 500,000 patients each year in the United States and is fatal in 300,000 patients annually. Underuse of pharmacologic VTE prophylaxis among surgical patients has been well-documented in the literature. Moreover, in the absence of formal VTE risk assessment, clinicians may underestimate overall risk by as much as 50%, leading to further underutilization of chemoprophylaxis. In 2005, after careful review of reports specific to our medical center from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), we noted that our institution had an unacceptably high rate of postoperative VTE.