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.