Adherence to Prophylaxis Guidelines for Symptomatic Venous Thromboembolism at a Darwin Hospital

To investigate adherence to venous thromboembolism (VTE) prophylaxis guidelines in patients who developed VTE within 90 days of hospital discharge. Method: Inpatients diagnosed with VTE (January 2007 to December 2009) were identified retrospectively from the medical records coding department. Patients were ineligible if they were outpatients, admitted to another hospital in the 3 months prior to the diagnosis of VTE, or if the diagnosis was not confirmed via a Doppler ultrasound or computed tomography pulmonary angiogram scan. A single cycle audit measured adherence to the guidelines by comparing prophylaxis delivered to eligible patients prior to the diagnosis of VTE to the prophylaxis recommended by the hospital guidelines. Results: 59 medical and surgical patients were eligible (median age 62 years; interquartile range 23 to 84) and 59% (n = 35) were male. Adherence to VTE prophylaxis guidelines was investigated for 59 patients who developed VTE associated with their current indexed admission (n = 32) or within 90 days of discharge (n = 27). Adherence to VTE prophylaxis for high-risk patients who developed VTE was: 50% for pharmacological prophylaxis and 57% for mechanical prophylaxis in surgical patients, and 63% for pharmacological prophylaxis and 26% for mechanical prophylaxis in medical patients. Conclusion: Nearly half of the patients had not received appropriate VTE prophylaxis prior to developing VTE.