Journal of Clinical Oncology, 2007 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 25, No 18S (June 20 Supplement), 2007: 19648
© 2007 American Society of Clinical Oncology

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Abstract

Preventing the Preventable—Improving thromboprophylaxis in oncology in-patients

South West Wales Cancer Institute, Swansea, United Kingdom

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Background: Cancer and its treatments are well recognised risk factors for venous thromboembolism (VTE). The risk of VTE complications in malignancy can be increased with surgery, chemotherapy (including adjuvant chemotherapy), hormone therapy and central indwelling catheters. Low molecular weight heparin (LMWH) has been shown to safely reduce the incidence of VTE in cancer patients however it is often not a standard of care within the oncology in-patient setting. Method: A retrospective study was carried out on admissions to the oncology ward for 1 month. Individual VTE risk was assessed using the modified THRiFT II risk assessment model and it was documented whether patients received any form of prophylaxis and the incidence of VTE. Following this study a VTE prophylaxis protocol was designed and implemented on the oncology ward and a repeat prospective study was carried out. Results: The initial study showed that in the very high risk group only 15% patients received thromboprophylaxis. 4 episodes of VTE occurred during the initial study period and these all occurred in patients stratified as very high risk. On the repeat study the results showed 50% of patients assessed as very high risk were now receiving prophylaxis. There was also a reduction in the rate of inappropriate prophylaxis from 17% to 0% in those assessed as lower risk. Conclusion: Primary prevention of VTE helps to reduce the morbidity and mortality associated with this common complication of malignancy. This study shows how a simple risk assessment model coupled with raised awareness of VTE risk improved the prophylaxis of those at highest risk and also reduced inappropriate usage in those at lesser risk.

No significant financial relationships to disclose.