• César Rincón Díaz, Sònia Jiménez Hernández, Fahd Beddar Chaib, Ana Isabel Condon Abanto, María Cortés Ayaso, Laura Lozano Polo, Leticia Guirado Torrecillas, Héctor Alonso Valle, Mónica Olid Velilla, David Jiménez, Ramón Lecumberri, Pedro Ruiz Artacho, and Grupo de trabajo de Enfermedad Tromboembólica Venosa de la Sociedad Española de Medicina de Urgencias y Emergencias (ETV-SEMES)*.
• Departamento de Medicina Interna, Clínica Universidad de Navarra, Madrid, España.
• Emergencias. 2024 Jun 1; 36 (4): 271280271-280.

ObjectiveTo estimate the prevalence of inappropriate use of prophylaxis to prevent venous thromboembolism (VTE) in patients with medical diseases admitted to hospital from the emergency department. To explore variables associated with inappropriate thromboprophylaxis.MethodsProspective multicenter cohort study in 15 hospital emergency departments. We included patients admitted for a medical condition during 7 days in the first quarter of 2022. We assessed risk for VTE with the Padua Prediction Score (PPS). Inappropriate thromboprophylaxis was defined by failure to prescribe prophylaxis in patients with a high-risk PPS assessment unless there were absolute contraindications (active bleeding or severe thrombopenia) or, alternatively, the prescription of prophylaxis in patients with a low-risk PPS assessment or absolute contraindications. A logistic regression model was adjusted for risk level to identify variables associated with inappropriate use of thromboprophylaxis.ResultsOf a total of 630 patients included, 450 (71.4%) had PPS scores indicating high risk for VTE; 180 patients were at low risk. Thromboprophylaxis was inappropriate in 248 patients (39.4%): 165 high-risk patients who received no prophylaxis, 82 low-risk patients who were nonetheless treated, and 1 patient who was treated in spite of severe thrombopenia. Odds ratios (ORs) revealed that the variables associated with inappropriate use of thromboprophylaxis were trauma or recent surgery (OR, 5.53; 95% CI, 1.58-19.34), presence of factors indicating risk for bleeding (OR, 2.61; 95% CI, 1.44-4.73), and hospital admission for either urinary tract infection (OR, 2.29; 95% CI, 1.07-4.87) or gastrointestinal disease (OR, 4.30; 95% CI, 1.71-10.85).ConclusionsThe inappropriate use of thromboprophylaxis in Spanish emergency departments is high and associated with certain clinical characteristics.

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