A Retrospective Evaluation of Adherence to Guidelines for Prevention of Thromboembolic Events in General Medical Inpatients
Bibliographic record
Abstract
ABSTRACT Background: Venous thromboembolism is a frequently occurring disorder associated with significant morbidity, mortality, and resource expenditure. Although most venous thromboembolic incidents occur in medical patients, standardized protocols for thromboprophylaxis in such patients have not been implemented at the authors’ institutions. Objective: To compare institutional thromboprophylactic practices for medical patients with current guidelines. Methods: A chart review was performed for patients admitted to the medical wards of 2 university-affiliated hospitals over a 7-month period. Patients were included if they had one major risk factor and/or at least 2 minor risk factors for venous thromboembolism. The primary endpoint was the rate of thromboprophylaxis during hospital admission. Results: A total of 131 subjects were included in the analysis. The rate of thromboprophylaxis was 21%, was similar in subjects with and without major or minor contraindications to pharmacologic prophylaxis, and did not differ by age. Two patients, both of whom received thromboprophylaxis, experienced a venous thromboembolic event. In patients who received thromboprophylaxis, unfractionated heparin was the most common agent. Of patients who received thromboprophylaxis, approximately 7% experienced a minor bleed and 7% experienced a major bleed. Conclusions: Among medical patients at the authors’ institutions with risk factors for venous thromboembolism, a small proportion received thromboprophylaxis, which reflects poor adherence to current guidelines. The low rate of prophylaxis was not explained by contraindications to prophylaxis or the age of the subjects. ABSTRACT Historique : La thromboembolie veineuse est une affection frequente qui entraine de la morbidite, de la mortalite et des depenses en ressources significatives. Bien que la plupart des accidents thromboemboliques veineux surviennent chez les patients admis aux services de medecine, des protocoles de thromboprophylaxie standardises pour de tels patients n’ont pas ete mis en oeuvre dans les etablissements ou sont rattaches les auteurs. Objectif : Comparer les pratiques de thromboprophylaxie utilisees chez les patients admis aux services de medecine dans ces etablissements a celles des lignes directrices actuelles. Methodes : On a evalue les dossiers medicaux des patients admis aux unites de medecine de deux hopitaux universitaires sur une periode de sept mois. Les patients etaient retenus s’ils presentaient un facteur de risque principal et (ou) au moins deux facteurs de risque secondaires de thromboembolie veineuse. Le critere d’evaluation primaire etait le taux de thromboprophylaxie durant le sejour a l’hopital. Resultats : Au total, 131 sujets ont ete inclus dans l’analyse. Le taux de thromboprophylaxie a ete de 21 %, et etait semblable que les sujets aient eu ou non des contre-indications mineures ou majeures de la prophylaxie medicamenteuse, et ne differait pas selon l’âge. Deux patients, qui ont tous deux recu une thromboprophylaxie, ont eu un accident thromboembolique veineux. Chez les patients qui ont recu une thromboprophylaxie, l’heparine non fractionnee etait l’agent le plus souvent utilise. Parmi les patients qui ont recu une thromboprophylaxie, environ 7 % ont eu des saignements mineurs et 7 % des saignements majeurs. Conclusions : Une faible proportion des patients admis aux services de medecine dans les etablissements ou sont rattaches les auteurs et presentant un risque de thromboembolie veineuse ont recu une thromboprophylaxie, ce qui reflete une timide adhesion aux lignes directrices actuelles. Le faible taux de prophylaxie ne pouvait etre explique par des contre-indications de la prophylaxie ou l’âge des sujets.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".