Vnitr Lek 2005, 51(5):518-522

Prevention of venous thrombosis and pulmonary embolism in the department of internal medicine

J. Spáčil^1,2,*, J. Spáčilová¹

¹ III. interní klinika 1. lékařské fakulty UK a VFN, Praha, přednosta prof. MUDr. Š. Svačina, DrSc., MBA

² Subkatedra angiologie IPVZ, vedoucí MUDr. J. Spáčil, CSc.

From recent large controlled studies it is known that prevention of venous thrombosis and pulmonary embolism with heparin or low-molecular heparin in patients treated in the internal departments is indicated, effective and safe in all patients who have two and more risk factors for these disorders and who are not contraindicated. However, it is not known how the prevention is performed in practice, therefore we analysed clinical records of deceased with diagnosis of pulmonary embolism during two years and we studied clinical records of 411 patients hospitalised in the 3^rd Medical Department of the 1^st Faculty of Medicine and General Teaching Hospital during last months. We assessed the risk of venous thrombosis and pulmonary embolism and how their prevention with heparin or low-molecular heparin is practised. 69 patients died with the diagnosis of pulmonary embolism during two years. Autopsy was done in 40 patients and the diagnosis was confirmed in 25%. We found that pharmacological prevention was performed in 52%. The prevention was indicated in 200 patients from 411 hospitalised patients, i.e. in 48.7%. In these patients, where the pharmacological prevention was indicated, in fact it was not performed in 49% and it was done in 51%. In these patients the prevention was performed sufficiently in 60%, while suboptimal doses of heparin or low-molecular heparin were used in 40%. The situation was least favourable in patients with malignant tumours. The degree of pharmacological prevention of venous thrombosis and pulmonary embolism is not ideal in our clinic; however it is similar or even better than it is shown in world research literature where this topic seems to be still sporadic. The results imply that prevention of thromboembolic disease in patients in hospital's internal departments is not performed extensively and intensively enough.

Keywords: venous thrombosis; pulmonary embolism; prevention; heparin

Received: July 7, 2004; Accepted: August 26, 2004; Published: May 1, 2005  Show citation