DVT prophylaxis in relation to patient risk profiling – the TUNE-IN study

Abstract

Background. Patients in acute hospital care show a high risk for venous thromboembolism (VTE); 52% of patients globally are at risk, with approximately only half receiving appropriate prophylaxis. Objectives. The TUNE-IN study’s primary objective was to evaluate the use of VTE prophylaxis in the private sector in South Africa in hospitalised patients in relation to patient risk profile, via both a clinical assessment and utilising a modified risk assessment model (RAM). The secondary objective was to evaluate the relationship between prophylaxis and the level of mobility at discharge as well as on days 3, 7 and 14 post discharge. Results. Of the 608 patients enrolled, 54.1% were evaluated to be at risk for VTE clinically whilst, with RAM assessment, 74.6% were assessed at risk. Adequate prophylaxis was given to only 70.9% of all patients. Conclusion. Data appear to correlate with global findings (ENDORSE study): more than 50% of hospitalised patients are at risk for VTE. Clinical risk assessment does not correlate with RAM utilisation, resulting in possible over-diagnosis of VTE risk in lowand moderate-risk patients, with the converse happening in highand highest-risk patients. Certain risk groups are easily defined for VTE risk (e.g. major orthopaedic surgery), but individual risk assessment is crucial as it often reveals underlying and overlooked risk factors, with BMI and age the most frequently overlooked risk factors.

S Afr Med J 2012;102:85-89