Intern Med J. 2021 Nov 1. doi: 10.1111/imj.15600. Online ahead of print.
BACKGROUND: Hospital-acquired venous thromboembolism (VTE) is a major cause of morbidity and mortality.
AIM: Our study aimed to determine the proportion of patients with hospital-acquired VTE that are preventable.
METHODS: This was a retrospective study of patients in two tertiary care hospitals in Sydney, Australia. Data were collected for patients with hospital-acquired VTE based on ICD-10-AM coding from January 2018 to May 2020. Patients were classified as low, moderate or high risk of developing a VTE during hospitalization based on demographic and clinical factors. A hospital-acquired VTE was considered to be potentially preventable if there was suboptimal prophylaxis in the absence of contraindications. Suboptimal therapy included at least one of the following related to VTE prophylaxis: low dose, missed dose (prior to developing a VTE), suboptimal drug, and delayed start (>24 hours from admission).
RESULTS: There were 229 patients identified with VTE based on ICD-10-AM coding. A subset of 135 were determined to have actual hospital-acquired VTEs. Of these, there were no patients at low risk, 64% (87/135) at moderate risk, and 44% (48/135) at high risk of developing a VTE. Most patients (65%, n=88/135) had one or more contraindications to receive recommended prophylaxis. Overall, the proportion of patients who received suboptimal prophylaxis was 11% (15/135).
CONCLUSION: Approximately, 1 in 10 hospital-acquired VTE are preventable. Hospitals should focus on measuring and reporting VTE that are preventable to provide a more accurate measure of the burden of VTEs that can be reduced by improving care. This article is protected by copyright. All rights reserved.