PS-070 Thromboprophylaxis optimisation in a cohort of neurocritical patients

BackgroundNeurocritical patients have a significant risk of developing further venous thromboembolisms. Therefore, appropriate use of pharmacological and mechanical thromboprophylaxis (TP) is needed to reduce the incidence of these events.PurposeThe aim of this study was to compare the use of TP in two cohorts of neurocritical patients, before and after implementation of corrective measures.Material and methodsA retrospective study of the use of TP was performed in two cohorts of neurocritical patients during their stay in the intensive care unit (ICU). The study was undertaken for the period of time from July to September 2013, and from July to September 2016. Demographic and TP related data were collected. Patients with anticoagulant therapy prior to hospital admission were not included.ResultsWe included 30 patients (86.6% men), mean age 45.5 years (16–80) in 2013, and 20 patients (75% men), mean age 48.7 years (17–83) in 2016. Median length of stay in the ICU was 17 days (3–51) in 2013 and 16 days (4–48) in 2016. The main diagnoses at admission in 2013 and 2016 were, respectively, acute spinal cord injury (30% vs 50%), stroke (26.6% vs 0%), head injury (23.3% vs 35%) and subarachnoid haemorrhage (3.3% vs 15%). 2013 2016 Mechanical prophylaxis alone (intermittent pneumatic compression, IPC) Treated patients3.8%15%MST1.71 (same day)MTD12.318.5 Pharmacological prophylaxis alone (LMWH) Treated patients48.1%20%MST5.43.25MTD8.710 Mixed prophylaxis (IPC+LMWH) Treated patients48.1%65%MST13.74.8MTD11.919.8MST, mean days before treatment; MTD, mean days of treatment.ConclusionAfter TP corrective measures were implemented, we observed the following improvements:100% of patients received some method of TP, exceeding the 90% recommended by the Spanish Intensive Society (quality indicator selected), and higher than in 2013 (90%).There was an improvement in TP startup time, both mechanical TP and pharmacological TP, as recommended by different clinical practice guidelines.An increase in the use of mechanical (51.9% vs 80%) and mixed prophylaxis (48% vs 65%) was documented.No conflict of interest