Atualização em tromboembolismo venoso: profilaxia em pacientes clínicos - parte I

Rocha, Ana Thereza; Paiva, Edison Ferreira de; Bernardo, Wanderley Marques

doi:10.1590/s0104-42302009000300012

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“…Mais recentemente, Rocha (2010) criou estruturas formais de tromboprofilaxia venosa para aplicar a diretriz brasileira apoiada pela AMB, para tromboprofilaxia venosa em pacientes clínicos, em quatro hospitais na Bahia 68 . A intervenção incluiu a divulgação da diretriz através de palestras e algoritmos.…”

Section: Proposta Do National Institute For Clinical Excelenceunclassified

Tromboprofilaxia: recomendações médicas e programas hospitalares

Bastos¹,

Barreto

Caiafa³

et al. 2011

Revista da Associação Médica Brasileira

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Section: Proposta Do National Institute For Clinical Excelenceunclassified

Tromboprofilaxia: recomendações médicas e programas hospitalares

Bastos¹,

Barreto

Caiafa³

et al. 2011

Revista da Associação Médica Brasileira

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“…Despite the development of methodologically rigorous clinical practice guidelines that inform the prevention and treatment of VTE, adherence to such practices by healthcare professionals (HCP) is suboptimal. For example, although VTE-associated mortality has decreased considerably in surgical patients who receive postoperative thromboprophylaxis, in the high-risk patient groups identified above, thromboprophylaxis is commonly suboptimal and mortality rates remain high, with thrombosis being the second major cause of death in patients with cancer [4–7]. Moreover, overall survival of patients with cancer and VTE is shorter than those without VTE, even when accounting for tumour stage and cancer treatment [6, 7], and in critically ill patients, between 7 and 27% of deaths are due to PE [8].…”

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confidence: 99%

Evaluation of unmet clinical needs in prophylaxis and treatment of venous thromboembolism in high-risk patient groups: cancer and critically ill

et al. 2019

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Background Clinical practice shows that venous thromboembolism (VTE) presents a substantial burden in medical patients, and awareness and advocacy for its primary and secondary prevention remains inadequate. Specific patient populations, such as those with cancer and the critically ill, show elevated risk for VTE, bleeding or both, and significant gaps in VTE prophylaxis and treatment exist in these groups. Objective To present novel insights and consolidated evidence collected from experts, clinical practice guidelines and original studies on the unmet needs in thromboprophylaxis, and on the treatment of VTE in two high-risk patient groups: patients with cancer and the critically ill. Methodology To identify specific unmet needs in the management of VTE, a methodology was designed and implemented that assessed gaps in prophylaxis and treatment of VTE through interviews with 44 experts in the field of thrombosis and haemostasis, and through a review of current guidelines and seminal studies to substantiate the insights provided by the experts. The research findings were then analysed, discussed and consolidated by a multidisciplinary group of experts. Results The gap analysis methodology identified shortcomings in the VTE risk assessment tools, patient stratification approaches for prophylaxis, and the suboptimal use of anticoagulants for primary prophylaxis and treatment. Conclusions Specifically, patients with cancer need better VTE risk assessment tools to tailor primary thromboprophylaxis to tumour types and disease stages, and the potential for drug–drug interactions needs to be considered. In critically ill patients, unfractionated heparin is not advised as a first-line treatment option, and the strength of evidence is increasing for direct oral anticoagulants as a treatment option over low-molecular-weight heparins. Electronic supplementary material The online version of this article (10.1186/s12959-019-0196-6) contains supplementary material, which is available to authorized users.

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Atualização em tromboembolismo venoso: profilaxia em pacientes clínicos - parte I

Cited by 2 publications

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Tromboprofilaxia: recomendações médicas e programas hospitalares

Tromboprofilaxia: recomendações médicas e programas hospitalares

Evaluation of unmet clinical needs in prophylaxis and treatment of venous thromboembolism in high-risk patient groups: cancer and critically ill

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