Survey of the use of thromboprophylaxis for medical patients at Christchurch Hospital

Aim. To determine the level of utilisation of thromboprophylaxis in relatio n to risk factors for medical patients at Christchurch Hospital. Methods. All medical wards were surveyed three times over a 12-week period from January 1998. Patients currently under investigation for venous thromb oembolism were excluded, as were those currently receiving anticoagulant tr eatment for unrelated disorders. Primary prophylaxis was defined as the use of low-dose heparins or elastic stockings in asymptomatic patients. Patien ts with two or more risk factors were defined as being at high risk. Results. Three hundred and eighty-seven patients were interviewed of whom 8 0% were considered to be potentially eligible for primary prophylaxis. One hundred and one patients (33%) were at high risk, of whom 20 (20%) were giv en primary prophylaxis. Cancer, confinement to bed, recent surgery and hear t failure were the most common risk factors. Elastic stockings and low-dose heparin were employed in the same proportion of high risk cases but no pat ient received both. Patients with cancer were less likely to receive thromb oprophylaxis than those with the other risk factors. Overall, only about 7% of high-risk patients received thromboprophylaxis for more than 75% of the duration of their stay in hospital. Conclusion. Thromboprophylaxis is underutilised at Christchurch Hospital. G uidelines are required and audits of compliance are indicated.