Profilaxis de enfermedad tromboembólica en pacientes hospitalizados con patología médica, estrechando la brecha entre las guías y la práctica clínica / Strategies for the prophylaxis of thromboembolic disease among medical patients

ABSTRACT

Thromboembolic disease is the main preventable cause of in-hospital death. Approximately 10 percent of nosocomial deaths are attributable to pulmonary embolism and in most cases, the diagnosis is not suspected before the autopsy. There are cost effective measures to decrease the incidence of thromboembolic disease. Pharmacological prophylaxis decreases the incidence of deep venous thrombosis by 65 percent and the incidence of pulmonary embolism by 35 to 55 percent. Despite this data and the presence of clinical guidelines, prophylaxis of thromboembolic disease is used only in 40 percent of medical patients and in 65 percent of surgical patients with recommended indications. We review the evidence that supports the use of thromboprophylaxis and the different strategies that may increase the compliance of physicians with its use. A protocol implemented in our institution is also proposed.