D Hayoz

Publications (2)10.97 Total impact

• Source

  Available from: brunnerhess.ch

  Article: Swiss Atherothrombosis Survey: a field report on the occurrence of symptomatic and asymptomatic peripheral arterial disease.

  D Hayoz, H Bounameaux, C R Canova
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  ABSTRACT: To investigate the Ankle/Brachial Pressure Index (ABI) for its suitability in daily practice to identify patients at atherothrombotic risk. To collect data on the prevalence of atherothrombotic events [coronary artery disease (CAD), stroke/transient ischaemic attack (TIA)], of 'hidden' (asymptomatic) versus 'known' (symptomatic) peripheral arterial disease (PAD) and treatment in the general practice population. Field survey from everyday Swiss practice. On five consecutive workdays, 276 doctors documented all patients, recording gender, age, history of atherothrombotic events, risk factors and family history. In the case of a previous stroke/TIA and/or CAD, or two or more risk factors were present at age >55, the ABI was determined. A total of 25,351 patients were included and 3921 ABI measurements were performed in eligible patients. Practices of primary care doctors. All patients who visited one of the 276 participating doctors on one of five consecutive workdays were included in the survey. Data recording and measurement of the ABI on those patients who qualified. Of the patients 3.7% had symptomatic PAD. An additional 2.7% of hitherto asymptomatic patients were identified as being at high atherothrombotic risk by having an ABI value <0.9. Exactly 93.9% of the participating doctors considered the ABI measurement easy to incorporate into the diagnostic routine of patients presenting with risk factors. The ABI measurement is an easy-to-use, noninvasive and reliable means to identify patients at risk of atherothrombotic events. Identification of asymptomatic PAD leads to intensified targeted prophylactic atherothrombotic treatment that can reduce morbidity and mortality.
  Journal of Internal Medicine 09/2005; 258(3):238-43. · 5.48 Impact Factor
• Source

  Available from: Pierre Chopard

  Article: Venous thromboembolism prophylaxis in acutely ill medical patients: definite need for improvement.

  P Chopard, J Dörffler-Melly, U Hess, W A Wuillemin, D Hayoz, A Gallino, E B Bachli, C R Canova, J Isenegger, R Rubino, H Bounameaux
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  ABSTRACT: To examine the frequency and adequacy of thromboprophylaxis in acutely ill medical patients hospitalized in eight Swiss medical hospitals. A cross-sectional study of 1372 patients from eight Swiss hospitals was carried out. After exclusion of patients (275) given therapeutic anticoagulation, 1097 patients were audited. The adequacy of thromboprophylaxis was assessed by comparison with predefined explicit criteria. Of 1097 patients, 542 (49.4%) received thromboprophylaxis. According to the explicit criteria, 644 (58.7%) should have been on prophylaxis (P < 0.001, when compared with the rate observed). The rate of prevention differed widely between hospitals (from 29.4 to 88.6%) with no difference between teaching and nonteaching hospitals. According to the explicit criteria, a substantial proportion (44.9%) of the patients who should have been treated were not. Conversely, 41.3% of the patients were unnecessarily treated. Even though the appropriateness of the explicit criteria used could be challenged, our data suggest that the current practice is associated with important uncertainty leading to both overuse and underuse of thromboprophylaxis in patients hospitalized in medical wards. More efforts are urgently needed to develop new or endorse existing explicit, evidence-based criteria and guidelines for thromboprophylaxis in this population of patients.
  Journal of Internal Medicine 04/2005; 257(4):352-7. · 5.48 Impact Factor