The AVAIL ME extension: a multinational Middle Eastern survey of VTE risk and prophylaxis.
J Thromb Haemost. 2011 May 23;
Authors: Mokhtari M, Salameh P, Kouchek M, Kashani BS, Taher A, Waked M,
Background: Venous thromboembolism (VTE) is a major worldwide problem. Objectives: The primary objectives of this survey were to identify patients at risk for VTE, to define the rate of patients receiving appropriate VTE prophylaxis and to examine the frequency of guideline presence and their application. Patients and Methods: Ten countries, 101 hospitals and a total of 4,983 patients were included in this multinational cross-sectional survey. Standardized case report forms were filled out by trained individuals on one predefined day. Risks were categorized according to Caprini Risk Assessment Model. Logistic regressions were carried out to assess factors that determined VTE prophylaxis. Results: Of 4,983 patients 3,368(68%) and 1,615(32%) were surgical and medical respectively. 772(15.5%) were considered to be at low risk, 1001(20%) at moderate risk, 1289(26%) at high risk and 1921(38.5%) at very high risk for VTE. Of 3,575(72%) patients who were eligible to receive VTE prophylaxis, 2,747(77%) received any drug prophylaxis. Among these patients 720/1056(68%) and 2027/2519(80%) were medical and surgical patients respectively. The overall compliance to ACCP guidelines was 38%, with medical being 24% and surgical 44%. Conclusion: The results of this large multinational survey, although indicating overall improvement in VTE prophylaxis, identify a considerable number of patients who either did not receive any VTE prophylaxis or received it inappropriately. Although more medical patients were at risk for VTE, they were given prophylaxis less frequently than surgical patients. Concordance with VTE prophylaxis guidelines was higher in surgical patients, but overall application of these tools was unacceptably low.
PMID: 21605327 [PubMed - as supplied by publisher]