ABSTRACT
BACKGROUND: There is limited data on the use of thromboprophylaxis in patients with advanced cancer. We therefore aimed to study the practice of thromboprophylaxis in palliative care units in Austria. METHODS: We monitored use, indication, and contraindications to thromboprophylaxis in 134 patients hospitalized in 21 palliative care units in a prospective, cross-sectional study. RESULTS: Forty-seven percent of patients were on low molecular weight heparin on the day of the study for primary or secondary thromboembolism. Thromboprophylaxis had been withdrawn in 18% of the patients upon admission to the palliative care unit. Contraindications for thromboprophylaxis were present in 27% of all patients. Cancer was present in 86% of the patients. The use of thromboprophylaxis was similar in cancer patients and in non-cancer patients (49% vs. 42%). Contraindications for thromboprophylaxis were present in 24% of all cancer patients. Significantly more bedridden cancer patients had contraindications for prophylaxis when compared with mobile cancer patients (35% vs. 16%; p = 0.03). Low performance status was by far the most frequent contraindication among these patients (89%). Seventy-one percent of all bedridden cancer patients were treated in accordance with common guidelines for thromboprophylaxis when contraindications were taken into account. Eighty-seven percent of patients who had been involved in decision making opted for getting prophylaxis. CONCLUSIONS: Our data reveal that about half of all cancer patients in palliative care units are treated with thromboprophylaxis. Low performance status was the most frequent contraindication for thromboprophylaxis.
Subject(s)
Palliative Care , Thrombosis/prevention & control , Aged , Aged, 80 and over , Austria , Female , Hospitalization , Humans , Male , Practice Guidelines as Topic , Prospective Studies , Surveys and QuestionnairesABSTRACT
Progressive cancer leads to loss of quality of life. This is particularly true for head and neck cancers as they dramatically affect the patients and in addition to this psychological burden cause a lot of physical disabilities. Patients struggle against retreat and helplessness of their environment, feel ostracized and not any longer being a human. In advanced diseases, surgery is not the first choice of treatment. Ostensible control of symptoms, care of relatives and notice of psychosocial facts are the most important therapeutic issues in these patients. They gain the greatest benefit from palliative care with good control of symptoms. This is highlighted by the following case reports.
