Venous Thromboembolism Risk and Prophylaxis in the Acute Hospital Care Setting (ENDORSE study): Thailand Subgroup Analysis

Abstract

Abstract :

The incidence of venous thromboembloism (VTE) varies in different countries. Information on the variation in the risk for VTE and extent of prophylaxis practices worldwide is scarce, especially in Thailand. The ENDORSE (Epidemiologic International Day for Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting) study is a multinational cross-sectional survey. The study was designed to provide
such information by accessing the prevalence of VTE risk in the acute hospital care setting, and to determine the proportion of at-risk patients who receive effective prophylaxis. The eligible patients were those of age 18 years or older admitted to surgical wards or 40 years or older admitted to medical wards. The 2004 American College of Chest Physicians (ACCP) evidence-based consensus guidelines were used to assess VTE risk and to determine whether patients were receiving recommended VTE prophylaxis. Among 358 hospitals across 32 countries worldwide, 1,824 patients from 5 hospitals in Thailand were enrolled in the study, with 1,001 (54.9%) categorized as surgical and 823 (45.1%) as medical patients. A large proportion of Thai patients (56.1%) is at risk for VTE, but the rate of appropriate prophylaxis is very low (1.8%). On the basis of the 2004 ACCP criteria, only 3 (0.5%) out of 618 (61.7%) at-risk surgical patients received VTE prophylaxis compared to 15 (3.7%) out of 406 (49.3%) at-risk medical patients. The data reinforces the rationale for the use of hospital-wide strategies to assess patients' VTE risk and to implement measures that ensure that at-risk patients receive appropriate prophylaxis.