Home > Journals > International Angiology > Past Issues > Articles online first > International Angiology 2018 Feb 19



Publication history
Cite this article as


A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,37



International Angiology 2018 Feb 19

DOI: 10.23736/S0392-9590.18.03969-X


language: English

Prevention of venous thromboembolism through the implementation of a risk assessment tool: a comparative study in medical and surgical patients

Min Y. PARK 1, John P. FLETCHER 1, 2, 3, Carmen HOFFMANN 3, Alice LANCE 3, Fiona GAVEGAN 3, Kerry HITOS 1, 2, 3

1 Westmead Clinical School, Westmead Hospital, The University of Sydney, Sydney, Australia; 2 Westmead Research Centre for Evaluation of Surgical Outcomes, University of Sydney, Sydney, Australia; 3 Department of Surgery, The University of Sydney, Westmead Clinical School, Westmead Hospital, Sydney, Australia


BACKGROUND: Hospitalised patients are at high risk of venous thromboembolism (VTE). Underutilisation of thromboprophylaxis remains common despite existing clinical guidelines. The aim is to evaluate the implementation of a state wide standardised adult VTE risk assessment tool (RAT) to assist in the screening of inpatients and prescribing of appropriate thromboprophylaxis.
METHODS: In total, 234 patients were audited using clinical notes and spot assessments for VTE risk at Western Sydney Local Health District over a two year period. Patients were stratified into pre-(n=132) and post-implementation (n=102) of the RAT. Intervention involved continuing education of staff and passive dissemination of guidelines. Prescription of pharmacological and mechanical prophylaxis and the development of thromboembolic events were evaluated.
RESULTS: Overall, 39.0% of medical and 63.0% of surgical patients were risk assessed during pre-implementation versus 39.2% and 92.2% during post-implementation of the RAT (P<0.0001). Usage of pharmacological prophylaxis increased from 72% to 79% and mechanical prophylaxis from 41% to 48%. VTE rates in moderate to high risk medical patients decreased from 15.2% pre-implementation to 6.5% post-implementation. Rates of non-fatal and fatal pulmonary embolism (PE) were 2.3% and 0.8% respectively prior compared to 1.0% and 0.0% post-implementation.
CONCLUSIONS: Standardised VTE RAT increased thromboprophylaxis usage and decreased PE rates, with a greater improvement reflected in surgical patients. These findings highlight the importance of a multifaceted approach to VTE prevention using regular audits with feedback, electronic reminders systems, prescribing tools and continuing education.

KEY WORDS: Venous thromboembolism - Deep vein thrombosis - Pulmonary embolism - Risk Assessment - Thromboprophylaxis - Padua prediction score

top of page

Publication History

Article first published online: February 19, 2018
Manuscript accepted: February 14, 2018
Manuscript received: January 6, 2018

Cite this article as

Park MY, Fletcher JP, Hoffmann C, Lance A, Gavegan F, Hitos K. Prevention of venous thromboembolism through the implementation of a risk assessment tool: a comparative study in medical and surgical patients. Int Angiol 2018 Feb 19. DOI: 10.23736/S0392-9590.18.03969-X

Corresponding author e-mail