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  • Title: [Prevalence and prevention of venous thromboembolic events in general practice. Multicenter, prospective cohort study].
    Author: Pouchain D, Bergmann JF, Bosson JL.
    Journal: Rev Prat; 2008 Dec 15; 58(19 Suppl):3-8. PubMed ID: 19253785.
    Abstract:
    OBJECTIVE: To determine the incidence of clinical venous thromboembolic events in home-care patients presenting an acute condition resulting in a significant and transitory reduction in mobility. To describe the measures implemented to prevent thromboembolic risks. METHOD: Prospective, multicenter, observational cohort study conducted among 2,895 general practitioners randomly drawn, who included the first 6 eligible patients: outpatients aged 40 years and over in which a reduction in mobility longer than 48 hours was expected due to acute medical condition. The primary endpoint was the incidence of deep venous thrombosis and symptomatic pulmonary embolism at 3 weeks. RESULTS: 16,532 patients whose average age was 71 years were included between October 2002 and June 2003. The most common acute conditions resulting in a reduction in mobility were infections, acute rheumatologic diseases and falls without fracture. The incidences of deep venous thrombosis and symptomatic pulmonary embolism were respectively 1% (95% CI = 0.84-1.14) and 0.20% (95% CI = 0.13-0.27). Cancer and personal or family history of venous thromboembolic disease were independent risk factors for thromboembolic events. A thromboprophylaxis was initiated in 35% of patients. The main decisive factor for prescription was the personal history of venous thromboembolic disease. DISCUSSION: The risk of symptomatic venous thromboembolic disease in outpatients whose mobility is reduced for medical reasons is close to that described in hospitalized patients.
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