Evaluation of prophylaxis for venous thromboembolism in a university hospital intensive care unit

Abstract

Objectives: To assess the risk profile and prophylactic measures for venous thromboembolism (VTE) in clinical patients in an intensive care unit and the role of clinical pharmacists in risk assessment and VTE prophylaxis. Method: Cross-sectional study in an intensive care unit (ICU) of a University Hospital, where data were collected from 76 patients, clinical and surgical, monitored by clinical pharmacists from September to December 2020. Patients admitted on weekends with a hospital stay of less than 24-48 hours, pediatric patients, pregnant women or those who were already undergoing therapeutic treatment with anticoagulants were not included in the study. Data were captured from the analysis of medical prescription, clinical history and pharmaceutical evolution contained in electronic medical records. An assessment of the risk profile was performed using the Padua Scores for clinical patients and Caprini Score for surgical patients and the adequacy of VTE prophylaxis assessed according to the guidelines of the American College of Chest Physicians. Results: 76 patients were included, of which 64.7% were surgical and 35.3% clinical. Of the total number of patients, 67 (88.3%) were classified as high risk, of which 64.2% were surgical patients and 35.8% were clinical. As for pharmacological prophylaxis for VTE, 44.7% of the patients evaluated did not find prescribed chemoprophylaxis. As for the clinical performance of the pharmacist, in 13.1% of the adopted patients, there was a need for intervention to include pharmacological prophylaxis, with 13.4% at high risk of VTE. Conclusions: Patients admitted to the ICU have a high risk of developing VTE. Prophylactic measures for VTE are still inadequate in both clinical and Clinical patients, evidencing the importance of the role of the clinical pharmacist in the process of evaluating and implementing prophylactic measures for this condition.