Underutilization of Anticoagulant for Venous Thromboembolism Prophylaxis in Three Hospitals in Jakarta
ABSTRACT: to assess the
current use of anticoagulants and implementation of International Guidelines in
venous thromboembolism (VTE) prophylaxis in hospitalized patients with acute
medical illnesses in Jakarta, Indonesia Methods: a multicenter, prospective,
disease registry, recruiting patients diagnosed as acutely ill medical diseases
and other medical conditions at risk of VTE, with in-hospital immobilization
for at least 3 days. Results: of 401 patients, 46.9% received anticoagulants
which included unfractionated heparin (64.4%), fondaparinux (11.7%), enoxaparin
(9.6%), warfarin (3.7%), and combination of anticoagulants (10.6%). VTE
prophylaxis using physical and mechanical method was used in 81.3% of patients,
either as a single modality or in combination with anticoagulants. During
hospitalization, VTE were found in 3.2% patients; 10 patients (2.5%) had lower
limb events and 3 patients (0.75%) had a suspected pulmonary embolism. The main
reference international guidelines used were AHA/ASA 2007 (47.4%), followed by
ACCP 2008 (21.7%). Conclusion: the study showed underutilization of prophylaxis
anticoagulants in which mechanical thromboprophylaxis either alone or
combination with anticoagulants was the most commonly used. Unfractionated
heparin was the preferable choice. The most commonly used guideline was AHA/ASA
2007. VTE thromboprophylaxis in medically ill patients needs to be encouraged.
Author: T. Djumhana Atmakusuma
Journal Code: jpkedokterangg150248
