ARTÍCULO

High incidence of venous thromboembolism despite electronic alerts for thromboprophylaxis in hospitalised cancer patients.

Autores: Lecumberri Villamediana, Ramón; Marqués Girbau, Margarita; Panizo Morgado, Elena; Alfonso Piérola, Ana; Garíca, A; Gil Bazo, Ignacio; Hermida Santos, José María; Schulman , S; Páramo Fernández, José Antonio
Título de la revista: THROMBOSIS AND HAEMOSTASIS
ISSN: 0340-6245
Volumen: 110
Número: 1
Páginas: 184-190
Fecha de publicación: 2013
Resumen:
Many cancer patients are at high risk of venous thromboembolism (VTE) during hospitalisation; nevertheless, thromboprophylaxis is frequently underused. Electronic alerts (e-alerts) have been associated with improvement in thromboprophylaxis use and a reduction of the incidence of VTE, both during hospitalisation and after discharge, particularly in the medical setting. However, there are no data regarding the benefit of this tool in cancer patients. Our aim was to evaluate the impact of a computer-alert system for VTE prevention in patients with cancer, particularly in those admitted to the Oncology/Haematology ward, comparing the results with the rest of inpatients at a university teaching hospital. The study included 32,167 adult patients hospitalised during the first semesters of years 2006 to 2010, 9,265 (28.8%) with an active malignancy. Appropriate prophylaxis in medical patients, significantly increased over time (from 40% in 2006 to 57% in 2010) and was maintained over 80% in surgical patients. However, while e-alerts were associated with a reduction of the incidence of VTE during hospitalisation in patients without cancer (odds ratio [OR] 0.31; 95% confidence interval [CI], 0.15-0.64), the impact was modest in cancer patients (OR 0.89; 95% CI, 0.42-1.86) and no benefit was observed in patients admitted to the Oncology/Haematology Departments (OR 1.11; 95% CI, 0.45-2.73). Interestingly, 60% of VTE episodes in cancer patients during recent years developed despite appro