| Sub-title | |
| Authors | D Cachia J Pocock A J Cassar M Magro |
| Abstract | Background: Venous thromboembolism (DVT/PE) is a common medical condition with an excellent prognosis once appropriate treatment is started. Inadequate treatment on the other hand is associated with a high mortality. Guidelines for the treatment of DVT have recently been published in the New England Journal of Medicine. Aim of audit: To assess if DVT management at St Luke's Hospital follows these guidelines and identify any pitfalls in management. Methodology: All patients admitted with a suspected diagnosis of DVT/PE during the year 2004 were identified. From these 400 patients, 100 were randomly chosen. The relevant data was inserted on a prepared data sheet from the patients' medical records. Results: Out of the 100 patients selected, only 41 were diagnosed with DVT/PE. In more than half the patients the diagnostic investigation of choice was a venogram. The most common risk factors for DVT/PE were immobilization, cancer and a previous DVT. Regarding management flaws, in a significant number of patients (12) a heparin loading dose was not given. In 12 patients the target APTT ratio was not reached within 2 days of starting anticoagulation. In 12 patients, heparin was not given for the minimum duration of 5 days. An overlap of heparin and warfarin for 2 days after reaching the target INR was not done in the majority (25) of patients. 8 patients from the study population passed away, 2 of these dying from PE. The other 6 patients died from an underlying malignancy. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | 18 Supplement |
| Page | |
| Date | 01/12/2006 |
| Link to journal | |
| Key words | acute admission, audit, casualty, deep venous thrombosis, guidelines |