The risk and prevention of thromboembolic diseases in hospitalized patients

Venska tromboembolija medicinski je pojam koji se odnosi na duboku vensku trombozu i plućnu emboliju. Duboka venska tromboza predstavlja ugrušak u dubokoj veni, obično u nozi. Do plućne embolije dolazi kad se ugrušak odvoji od stjenke, putuje do pluća i prekida krvnu opskrbu. Ovo stanje, koje je lako prevenirati, česta je komplikacija u hospitaliziranih pacijenata. To se događa zbog hiperkoagulabilnosti, venske staze u donjim ekstremitetima i ozljede endotela. Tromboprofilaksa indicirana je u bolesnika s nekim od sljedećih rizičnih čimbenika: dob, komorbiditeti, pretilost, pušenje, veći kirurški zahvat, maligna bolest, trudnoća, hormonska nadomjesna terapija, imobilizacija, prethodna venska tromboembolija ili venska tromboembolija u obiteljskoj anamnezi. Profilaksa heparinom dokazano značajno smanjuje rizik od plućne embolije u hospitaliziranih bolesnika. Preporučena je supkutana primjena heparina male molekularne mase (LMWH) ili intravenska primjena nefrakcioniranog heparina (UFH). Zadnje smjernice uključuju i nove oralne antikoagulanse u preporuke za profilaksu venske tromboembolije. Unatoč dokazima koji pokazuju značajnu korist, istraživanja pokazuju kako veliki broj hospitaliziranih bolesnika još uvijek ne prima adekvatnu tromboprofilaksu.Venous thromboembolism is a medical term that refers to deep vein thrombosis and pulmonary embolism. Deep vein thrombosis is a clot in a deep vein, usually in the leg. Pulmonary embolism occurs when a clot breaks free from a vein wall, travels to the lungs and blocks the blood supply. This largely preventable condition is a common complication in hospitalized patients. This is due to hypercoagulability, venous stasis of the lower extremities and endothelial injury. Thromboprophylaxis is indicated in medical patients with any of the following risk factors: age, medical comorbidities, obesity, smoking, major surgery, cancer, pregnancy, use of hormone replacement therapy, immobility, previous episode of venous thromboembolism or family history of venous thromboembolism. Prophylaxis with heparin has been shown to significantly reduce pulmonary embolism in hospitalized patients. It is recommended to administer subcutaneous low molecular weight heparin (LMWH) or intravenous unfractionated heparin (UFH). Latest guidelines include new oral anticoagulants in recommendations for venous thromboembolism prophylaxis. Despite the evidence demonstrating significant benefit, studies have shown that many hospitalized patients still do not receive appropriate thromboprophylaxis