A prospective study of the adequacy in the tromboprofilaxis in patients admitted in a short-stay unit

Introduction: numerous studies support the use of thromboprophylaxis in patients at risk of thrornboembolic disease (VTE) that require hospitalization. There is little evidence in the indications of thromboprophylaxis in the population of acut Htionts admitted to a Short Stay Unit. Objectives: to study the use of thromboprophylaxis in patients admitted to a Short Stay Unit of the Emergency Department of a tertiary hospital. Clinical variables (development of a three-month VTE event) and biochemical (anti-Xa activity levels) were evaluated. Methods: those patients with acute medical pathology with indication of thromboprophylaxis were included according to the PRETEMED guideline. The anti-Xa activity of each patient that met the inclusion criteria was determined. Cases of symptomatic VTE were identified, during hospital admission and later, in the three-month follow-up of the Emergency Department. Results: a total of 100 patients were included. The most frequent predisposing VTE risk factors were age (80 %> 60 years and 66 % > 70 years), neoplasia (28 %), COPD (28 %) and obesity (29 %). The most frequent risk factors were the presence of an acute infection (58 %), immobility (33 %) and chemotherapy (17%). According to the PRETEMED Guide, they were classified as low risk (0 %), medium (20 %) and high (80 %). In the 3 months of follow-up, 3 % of symptomatic VTE episodes were observed, none of these occurred during admission. 48 % of the patients were outside the range of anti Xa thromboprophylactic activity. The factors associated with this situation were being a woman, treatment with enoxaparin 20mg a day and greater weight.There were no statistically significant differences in the occurrence of thromboembolic complications in relation to anti-Xa activity levels. Conclusions: it is necessary to stratify the risk of VTE in all patients, also in those admitted to short stay units and opens the need to evaluate the recommended thromboprophylaxis doses. We observed an absence of correlation between clinical and biochemical efficacy criteria with the usual thromboprophylaxis guidelines, and it is questionable to recommend their monitoring.