Risk stratification for venous thromboembolism in hospitalized patients in a developing country: a prospective study.

Department of Hematology-Oncology and Quality Improvement Office, Jordan University Hospital, Amman, Jordan.
Journal of Thrombosis and Thrombolysis (Impact Factor: 1.99). 12/2008; 28(3):309-13. DOI: 10.1007/s11239-008-0291-1
Source: PubMed

ABSTRACT Venous Thrombo-Embolism (VTE) is a serious complication in hospitalized patients but can be preventable. This prospective study addresses risk factors assessment and the use of heparin in this population. About 2,496 non pediatric patients were admitted to Jordan University Hospital between June 12, 2007 and July 19, 2007. A random sample of 624 patients consisting of every fourth admission was chosen. The stratification of risk factors was assessed using Caprini model and the ACCP score. The mean age of the patients (229 males and 395 females) was 45.34 +/- 18.3 years. More than 80% of the admitted patients were considered at high risk for VTE but heparin was used in only 26% of the patients. The majority of our patients constitute a high-risk population. Implementation of strategies including educational sessions and risk stratification guidelines can reduce the incidence, morbidity, and mortality of VTE especially in developing countries.

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    ABSTRACT: Clinical practice guidelines and Risk Assessment Models (RAMs) are some useful tools to bring medical evidences into our daily clinical practice. Despite the improvement over the time, they still have some shortcomings. One of these shortcomings is the arbitrary cutoffs used in these tools to facilitate the decision making process. This problem is to some extent due to the "Black or White" approach of modern medicine in making the decisions, whilst in the real world and our daily practice we used mostly an uncertain approach, which is called recently as "Fuzzy" thinking approach. The authors of this article believe that the fuzzy type of thinking may resolve the above mentioned shortcomings of clinical practice guideline or risk assessment models and they tried to discuss about this using an example about Venous Thromboembolism related guidelines and RAMs.
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