array:23 [
  "pii" => "S2254887417301388"
  "issn" => "22548874"
  "doi" => "10.1016/j.rceng.2017.10.007"
  "estado" => "S300"
  "fechaPublicacion" => "2018-03-01"
  "aid" => "1446"
  "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Rev Clin Esp. 2018;218:112-4"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2
    "PDF" => 2
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0014256517302576"
      "issn" => "00142565"
      "doi" => "10.1016/j.rce.2017.10.004"
      "estado" => "S300"
      "fechaPublicacion" => "2018-03-01"
      "aid" => "1446"
      "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Rev Clin Esp. 2018;218:111-3"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 89
        "formatos" => array:2 [
          "HTML" => 56
          "PDF" => 33
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Correspondencia</span>"
        "titulo" => "&#193;reas de mejora en la tromboprofilaxis de pacientes m&#233;dicos hospitalizados"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "111"
            "paginaFinal" => "113"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Areas of improvement in thromboprophylaxis of hospitalized medical patients"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1875
                "Ancho" => 3417
                "Tamanyo" => 608850
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gu&#237;a de bolsillo difundida entre profesionales&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">CNI&#58; compresi&#243;n neum&#225;tica intermitente&#59; ETEV&#58; enfermedad tromboemb&#243;lica venosa&#59; FG&#58; filtrado glomerular&#59; HBPM&#58; heparinas de bajo peso molecular&#59; HNF&#58; heparina no fraccionada&#59; IMC&#58; &#237;ndice de masa corporal&#59; INR&#58; raz&#243;n internacional normalizada <span class="elsevierStyleItalic">&#40;International Normalized Ratio&#41;&#59;</span> UCI&#58; unidad de cuidados intensivos&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Mart&#237;n Asenjo, J&#46;M&#46; Mart&#237;n Guerra, I&#46; Usategui Mart&#237;n, L&#46;A&#46; S&#225;nchez Mu&#241;oz"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Mart&#237;n Asenjo"
              ]
              1 => array:2 [
                "nombre" => "J&#46;M&#46;"
                "apellidos" => "Mart&#237;n Guerra"
              ]
              2 => array:2 [
                "nombre" => "I&#46;"
                "apellidos" => "Usategui Mart&#237;n"
              ]
              3 => array:2 [
                "nombre" => "L&#46;A&#46;"
                "apellidos" => "S&#225;nchez Mu&#241;oz"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2254887417301388"
          "doi" => "10.1016/j.rceng.2017.10.007"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417301388?idApp=WRCEE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517302576?idApp=WRCEE"
      "url" => "/00142565/0000021800000002/v1_201802240414/S0014256517302576/v1_201802240414/es/main.assets"
    ]
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2254887417301546"
    "issn" => "22548874"
    "doi" => "10.1016/j.rceng.2017.09.006"
    "estado" => "S300"
    "fechaPublicacion" => "2018-03-01"
    "aid" => "1442"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and Sociedad Espa&#241;ola de Medicina Interna &#40;SEMI&#41;"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Rev Clin Esp. 2018;218:110-1"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2
      "PDF" => 2
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Correspondence</span>"
      "titulo" => "Validation of the NaURSE rule for predicting in-hospital mortality in nonagenarians"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "110"
          "paginaFinal" => "111"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Validaci&#243;n externa de la regla NaURSE para predecir mortalidad intrahospitalaria en nonagenarios"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "N&#46; P&#233;rez, I&#46; Urreta, M&#46; Elola, P&#46; Aranegui"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "P&#233;rez"
            ]
            1 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Urreta"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Elola"
            ]
            3 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Aranegui"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0014256517302345"
        "doi" => "10.1016/j.rce.2017.09.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256517302345?idApp=WRCEE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417301546?idApp=WRCEE"
    "url" => "/22548874/0000021800000002/v1_201802230423/S2254887417301546/v1_201802230423/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Correspondence</span>"
    "titulo" => "Areas of improvement in thromboprophylaxis of hospitalized medical patients"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "112"
        "paginaFinal" => "114"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46; Mart&#237;n Asenjo, J&#46;M&#46; Mart&#237;n Guerra, I&#46; Usategui Mart&#237;n, L&#46;A&#46; S&#225;nchez Mu&#241;oz"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "M&#46;"
            "apellidos" => "Mart&#237;n Asenjo"
            "email" => array:1 [
              0 => "miguel&#46;martin&#46;asenjo&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "J&#46;M&#46;"
            "apellidos" => "Mart&#237;n Guerra"
          ]
          2 => array:2 [
            "nombre" => "I&#46;"
            "apellidos" => "Usategui Mart&#237;n"
          ]
          3 => array:2 [
            "nombre" => "L&#46;A&#46;"
            "apellidos" => "S&#225;nchez Mu&#241;oz"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Medicina Interna&#44; Hospital Cl&#237;nico Universitario de Valladolid&#44; Valladolid&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#193;reas de mejora en la tromboprofilaxis de pacientes m&#233;dicos hospitalizados"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1877
            "Ancho" => 3419
            "Tamanyo" => 607686
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pocket guide disseminated among practitioners&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviation</span>&#58; BMI&#44; body mass index&#59; GFR&#44; glomerular filtration rate&#59; ICU&#44; intensive care unit&#59; INR&#44; international normalized ratio&#59; IPC&#44; intermittent pneumatic compression&#59; LMWHs&#44; low-molecular-weight heparins&#59; UFH&#44; unfractionated heparin&#59; VTE&#44; venous thromboembolism disease&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Venous thromboembolism &#40;VTE&#41; in nonsurgical patients represents 75&#37; of all cases of VTE in hospitalized patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">1&#44;2</span></a> Despite the effectiveness of thromboprophylaxis&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">3</span></a> recent international<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">4</span></a> and national<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">5</span></a> studies have shown that the procedure is often omitted&#44; reaching only 25&#8211;36&#37; of medical patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Given the magnitude of the problem and to determine the adequacy of thromboprophylaxis in hospitalized medical patients in our setting and the potential areas for improvement&#44; we conducted an observational descriptive study using the 2012 recommendations of the American College of Chest Physicians &#40;ACCP&#41; as the gold standard&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We included all patients hospitalized in the Department of Internal Medicine of University Clinic Hospital of Valladolid over 2 weeks&#44; excluding those who were treated with long-term anticoagulation and those hospitalized for acute VTE&#46; We collected demographic variables&#44; the reason for hospitalization&#44; contraindications for anticoagulation&#44; risk factors for VTE and hemorrhage and the type of thromboprophylaxis&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Of the 191 hospitalized patients&#44; 112 met the inclusion criteria and constituted the study population&#46; The patients&#8217; mean age was 75&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;5 years&#44; 61 &#40;46&#37;&#41; were women&#44; and 48 &#40;43&#37;&#41; had a glomerular filtration rate &#60;60<span class="elsevierStyleHsp" style=""></span>mL&#47;min&#46; The most common reason for hospitalization was infectious diseases &#40;44 patients&#44; 39&#46;2&#37;&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Twenty-six patients &#40;23&#37;&#41; presented some contraindication for anticoagulation &#40;in 94&#37; of the cases&#44; they were relative&#41;&#46; One hundred patients &#40;89&#37;&#41; had VTE risk factors&#44; the most common of which were severe acute infection &#40;43 cases&#44; 42&#37;&#41;&#44; prolonged immobility &#40;40 cases&#44; 35&#37;&#41;&#44; diabetes mellitus &#40;32 cases&#44; 28&#37;&#41;&#44; bedridden for more than 4 days &#40;26 cases&#44; 23&#37;&#41;&#44; obesity &#40;19 cases&#44; 17&#37;&#41; and heart failure &#40;16 cases&#44; 14&#37;&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Sixty-nine patients &#40;62&#37;&#41; had a high VTE risk &#40;according to the Padua Prediction Score<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">7</span></a> &#91;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#93;&#41;&#44; and 16 &#40;14&#37;&#41; patients had a high hemorrhagic risk &#40;score &#62;7 on the hemorrhagic risk scale developed from the IMPROVE registry<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">8</span></a> &#91;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#93;&#41;&#46; Prophylactic treatment was started with low-molecular-weight heparin &#40;LMWH&#41; in 77 patients &#40;69&#37;&#41;&#59; physical measures were not used in any case&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">In accordance with the 2012 ACCP recommendations&#44; 62 patients &#40;55&#37;&#41; received appropriate thromboprophylaxis&#44; while 32 &#40;29&#37;&#41; were overtreated and 18 &#40;16&#37;&#41; were undertreated&#46; Of the overtreated patients&#44; 22 &#40;69&#37;&#41; were patients with low-risk VTE treated with LMWHs&#44; 7 &#40;22&#37;&#41; were patients with high-risk VTE with LMWH doses greater than indicated&#44; and 3 &#40;9&#41; were patients with high-risk VTE with high hemorrhagic risk or contraindication for pharmaceutical prophylaxis who were treated with LMWHs&#46; As for the undertreated patients&#44; 10 &#40;55&#37;&#41; had high-risk VTE with no contraindication for prophylaxis and were not treated with LMWHs&#59; 8 &#40;44&#37;&#41; were patients with high-risk VTE with a high hemorrhagic risk or contraindication for pharmaceutical prophylaxis&#44; who were not administered physical measures&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">This study revealed areas of improvement in the thromboprophylaxis practiced in our setting&#44; given that its adequacy &#40;55&#37;&#41; was lower than that of other national<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">5&#44;9</span></a> and international studies&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a> This is partly explained by the broad definition of overtreatment used in the study&#44; which represented the leading cause of inadequacy &#40;29&#37; of all patients included in the study&#41;&#46; Although most of the hospitalized patients had a high risk of VTE &#40;62&#37;&#41; and therefore an indication for thromboprophylaxis&#44; the rest of the patients did not require it&#46; The use of objective VTE and hemorrhagic risk assessment scales would help improve the adequacy of thromboprophylaxis&#44; thereby avoiding the almost systematic prescription of LMWHs during patient admission&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">As with other series&#44; it is worth noting the scarce use of physical measures of thromboprophylaxis&#46; Although there is no solid evidence of their use in medical patients&#44; these physical measures are a good alternative for those with a high VTE risk and contraindication for LMWHs<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a> &#40;9&#46;8&#37; of the patients in our series&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Our center has therefore implemented improvement activities&#44; such as updating the thromboprophylaxis protocol&#44; the use of VTE and hemorrhage risk scales for adjusting the thromboprophylaxis to the patient&#39;s risk&#44; the dissemination of these scales during training sessions with all department practitioners and through pocket guides &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; However&#44; these passive methods are not sufficiently effective&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a> We will therefore continue getting feedback from practitioners&#44; analyzing activity registries and following the protocol &#40;individual&#47;group benchmarking&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In conclusion&#44; the adequacy of thromboprophylaxis in hospitalized medical patients is low in our setting&#46; We have started improvement measures &#40;standardized protocols&#41; as a first step in a broader strategy for the adequacy of thromboprophylaxis&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a></p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Mart&#237;n Asenjo M&#44; Mart&#237;n Guerra JM&#44; Usategui Mart&#237;n I&#44; S&#225;nchez Mu&#241;oz LA&#46; &#193;reas de mejora en la tromboprofilaxis de pacientes m&#233;dicos hospitalizados&#46; Rev Clin Esp&#46; 2018&#59;218&#58;112&#8211;114&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1877
            "Ancho" => 3419
            "Tamanyo" => 607686
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pocket guide disseminated among practitioners&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviation</span>&#58; BMI&#44; body mass index&#59; GFR&#44; glomerular filtration rate&#59; ICU&#44; intensive care unit&#59; INR&#44; international normalized ratio&#59; IPC&#44; intermittent pneumatic compression&#59; LMWHs&#44; low-molecular-weight heparins&#59; UFH&#44; unfractionated heparin&#59; VTE&#44; venous thromboembolism disease&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:12 [
            0 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fatal pulmonary embolism in hospitalised patients&#58; a necropsy review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Alikhan"
                            1 => "F&#46; Peters"
                            2 => "R&#46; Wilmott"
                            3 => "A&#46;T&#46; Cohen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/jcp.2003.013581"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Pathol"
                        "fecha" => "2004"
                        "volumen" => "57"
                        "paginaInicial" => "1254"
                        "paginaFinal" => "1257"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15563663"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiolog&#237;a hospitalaria de la enfermedad tromboemb&#243;lica venosa en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Guijarro Merino"
                            1 => "J&#46; Montes Santiago"
                            2 => "C&#46;M&#46; San Rom&#225;n Ter&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2008"
                        "volumen" => "131"
                        "numero" => "Suppl&#46; 2"
                        "paginaInicial" => "S2"
                        "paginaFinal" => "S9"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Making health care safer&#58; a critical analysis of patient safety practices"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46;G&#46; Shojania"
                            1 => "B&#46;W&#46; Duncan"
                            2 => "K&#46;M&#46; McDonald"
                            3 => "R&#46;M&#46; Wachter"
                            4 => "A&#46;J&#46; Markowitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Evid Rep Technol Assess"
                        "fecha" => "2001"
                        "volumen" => "43"
                        "paginaInicial" => "1"
                        "paginaFinal" => "668"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Venous tromboembolism risk and prophylaxis in hospitalised medically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;F&#46; Bergmann"
                            1 => "A&#46;T&#46; Cohen"
                            2 => "V&#46;F&#46; Tapson"
                            3 => "S&#46;Z&#46; Godhaber"
                            4 => "A&#46;K&#46; Kakkar"
                            5 => "B&#46; Deslandes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1160/TH09-09-0667"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thromb Haemost"
                        "fecha" => "2010"
                        "volumen" => "103"
                        "paginaInicial" => "736"
                        "paginaFinal" => "748"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20135072"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ENDORSE&#46; Riesgo de enfermedad tromboemb&#243;lica venosa y profilaxis antitromb&#243;tica en los pacientes ingresados en hospitales espa&#241;oles &#40;estudio ENDORSE&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;A&#46; Nieto Rodr&#237;guez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2009"
                        "volumen" => "133"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "e195S&#8211;226S"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevention of VTE in nonsurgical patients&#46; Antithrombotic therapy and prevention of thrombosis&#44; 9th ed&#58; American College of Chest Physicians Evidence-Based Clinical Practice Guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;R&#46; Kahn"
                            1 => "W&#46; Lim"
                            2 => "A&#46;S&#46; Dunn"
                            3 => "M&#46; Cushman"
                            4 => "F&#46; Dentali"
                            5 => "E&#46;A&#46; Akl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.11-3192"
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2012"
                        "volumen" => "141"
                        "numero" => "Suppl&#46; 2"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22396557"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A risk assessment model for the identification of hospitalized medical patients at risk for venous thromboembolism&#58; the Padua Prediction Score"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Barbar"
                            1 => "F&#46; Noventa"
                            2 => "V&#46; Rossetto"
                            3 => "A&#46; Ferrari"
                            4 => "B&#46; Brandolin"
                            5 => "M&#46; Perlati"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1538-7836.2010.04044.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Thromb Haemost"
                        "fecha" => "2010"
                        "volumen" => "8"
                        "paginaInicial" => "2450"
                        "paginaFinal" => "2457"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20738765"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factors at admission associated with bleeding risk in medical patients&#58; findings from the IMPROVE investigators"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "IMPROVE Investigators"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Decousus"
                            1 => "V&#46;F&#46; Tapson"
                            2 => "J&#46;F&#46; Bergmann"
                            3 => "B&#46;H&#46; Chong"
                            4 => "J&#46;B&#46; Froehlich"
                            5 => "A&#46;K&#46; Kakkar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.09-3081"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2011"
                        "volumen" => "139"
                        "paginaInicial" => "69"
                        "paginaFinal" => "79"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20453069"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adecuaci&#243;n de tromboprofilaxis en pacientes m&#233;dicos hospitalizados en Andaluc&#237;a&#46; Estudio multic&#233;ntrico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Navarro Puerto"
                            1 => "F&#46;J&#46; Medrano Ortega"
                            2 => "R&#46; Izquierdo Guerrero"
                            3 => "E&#46; Calder&#243;n Sandubete"
                            4 => "M&#46;L&#46; Buz&#243;n-Barrera"
                            5 => "I&#46; Mar&#237;n-Le&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.rce.2014.09.007"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "2015"
                        "volumen" => "215"
                        "paginaInicial" => "141"
                        "paginaFinal" => "147"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25439187"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Venous thromboembolism risk and prophylaxis in the acute hospital care setting &#40;ENDORSE study&#41;&#58; a multinational cross-sectional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;T&#46; Cohen"
                            1 => "V&#46;F&#46; Tapson"
                            2 => "J&#46;F&#46; Bergmann"
                            3 => "S&#46;Z&#46; Goldhaber"
                            4 => "A&#46;K&#46; Kakkar"
                            5 => "B&#46; Deslandes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(08)60202-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2008"
                        "volumen" => "371"
                        "paginaInicial" => "387"
                        "paginaFinal" => "394"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18242412"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "Available from&#58; <span class="elsevierStyleInterRef" id="intr0010" href="http://www.ahrq.gov/qual/vtguide/vtguide.pdf">http&#58;&#47;&#47;www&#46;ahrq&#46;gov&#47;qual&#47;vtguide&#47;vtguide&#46;pdf</span> &#91;accessed 15&#46;10&#46;17&#93;"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preventing hospital-acquired venous thromboembolism&#58; a guide for effective quality improvement&#46; Prepared by the Society of Hospital Medicine&#46; AHRQ Publication No&#46; 08-0075"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Maynard"
                            1 => "J&#46; Stein"
                            2 => "G&#46; Maynard"
                            3 => "J&#46; Stein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "August 2008"
                        "editorial" => "Agency for Healthcare Research and Quality"
                        "editorialLocalizacion" => "Rockville&#44; MD"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke &#40;CLOTS trial 1&#41;&#58; a multicentre&#44; randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Dennis"
                            1 => "P&#46;A&#46; Sandercock"
                            2 => "J&#46; Reid"
                            3 => "C&#46; Graham"
                            4 => "G&#46; Murray"
                            5 => "G&#46; Venables"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(09)60941-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2009"
                        "volumen" => "373"
                        "paginaInicial" => "1958"
                        "paginaFinal" => "1965"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19477503"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/22548874/0000021800000002/v1_201802230423/S2254887417301388/v1_201802230423/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "71813"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Correspondence"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021800000002/v1_201802230423/S2254887417301388/v1_201802230423/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887417301388?idApp=WRCEE"
]
Share
Journal Information
Share
Share
Download PDF
More article options
Correspondence
Areas of improvement in thromboprophylaxis of hospitalized medical patients
Áreas de mejora en la tromboprofilaxis de pacientes médicos hospitalizados
M. Martín Asenjo
Corresponding author
miguel.martin.asenjo@gmail.com

Corresponding author.
, J.M. Martín Guerra, I. Usategui Martín, L.A. Sánchez Muñoz
Servicio de Medicina Interna, Hospital Clínico Universitario de Valladolid, Valladolid, Spain

Purchase article

For the purchase of this article it is necessary to fill in the following form:

Afganistan
Albania
Alemania
Andorra
Angola
Anguilla
Antartica
Antigua and barbuda
Antillas holandesas
Arabia saudita
Argelia
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgica
Belice
Benin
Bermudas/antillas britanicas
Bhutan
Bolivia
Bosnia y herzegowina
Botswana
Brasil
Brunei darussalam
Bulgaria
Burkina faso
Burundi
Cabo verde
Camboya
Camerun
Canada
Chad
Chile
China
Chipre
Colombia
Comoros
Corea
Costa rica
Cote d´ivoire
Croacia
Cuba
Dinamarca
Djibouti
Dominica
East timor
Ecuador
Egipto
El salvador
Emiratos arabes unidos
Eritrea
Escocia
Eslovaquia
Eslovenia
España
Estados federados de micronesia
Estados unidos
Estonia
Etiopia
Fiji
Filipinas
Finlandia
Francia
Gabon
Gambia
Georgia
Ghana
Gibraltar
Grecia
Grenada
Groenlandia
Guadalupe
Guam
Guatemala
Guayana britanica
Guinea
Guinea ecuatorial
Guinea francesa
Guinea-bissau
Haiti
Holanda
Honduras
Hong kong
Hungria
India
Indonesia
Irak
Iran
Irlanda
Isla bouvet
Isla cocos (keeling)
Isla cook
Isla mauricio
Isla navidad
Isla norfolk
Islandia
Islas caiman
Islas falkland (malvinas)
Islas faroe
Islas georgia del sur y sandwich
Islas heard and mc donald
Islas marshall
Islas northern mariana
Islas salomon
Islas svalbard and jan mayen
Islas turks and caicos
Islas united states minor outlyi
Islas virgenes (britanicas)
Islas virgenes (u.s.a.)
Islas wallis and futuna
Israel
Italia
Jamaica
Japon
Jordania
Kazakhstan
Kenia
Kiribati
Kuwait
Kyrgyzstan
Lesoto
Letonia
Libano
Liberia
Libia arab jamahiriya
Liechtenstein
Lituania
Luxemburgo
Macao
Macedonia
Madagascar
Malasia
Malawi
Maldives
Mali
Malta
Marruecos
Martinica
Mauritania
Mayotte
Mexico
Monaco
Mongolia
Monserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Nicaragua
Niger
Nigeria
Niue
Noruega
Nueva caledonia
Nueva zelanda
Oman
Pakistan
Palau
Panama
Papua new guinea
Paraguay
Peru
Pitcairn
Polinesia francesa
Polonia
Portugal
Posesiones gran bretaña
Posesiones u.s.a.
Puerto rico
Qatar
Reino unido
Republica checa
Republica de africa central
Republica de cabo verde
Republica de congo
Republica de corea
Republica de moldova
Republica democratica de laos
Republica democratica del congo
Republica dominicana
Reunion
Ruanda
Rumania
Rusia
Sahara occidental
Saint kitts and nevis
Samoa
Samoa americana
San marino
San tomas y principe
San vincent and the grenadines
Santa lucia
Senegal
Serbia
Seychelles
Sierra leona
Singapur
Siria
Somalia
Sri lanka
St. helena
St. pierre and miquelon
Sudafrica
Sudan
Suecia
Suiza
Surinam
Swaziland
Tailandia
Taiwan republica de china
Tajikistan
Tanzania
Territorio de indias britanicas
Togo
Tokelau
Tonga
Trinidad and tobago
Tunisia
Turkmenistan
Turquia
Tuvalu
Ucrania
Uganda
Uruguay
Uzbekistan
Vanuatu
Vaticano
Venezuela
Vietnam
Yemen
Yugoslavia
Zambia
Zimbawe
Lebanon
Paises bajos
A coruña
Alava
Albacete
Alicante
Almeria
Asturias
Avila
Badajoz
Balears
Barcelona
Bizkaia
Burgos
Caceres
Cadiz
Cantabria
Castellon
Ceuta
Ciudad real
Cordoba
Cuenca
Girona
Granada
Guadalajara
Guipuzcoa
Huelva
Huesca
Jaen
La rioja
Las palmas
Leon
Lleida
Lugo
Madrid
Malaga
Melilla
Murcia
Navarra
Ourense
Palencia
Pontevedra
Salamanca
Segovia
Sevilla
Soria
Tarragona
Tenerife
Teruel
Toledo
Valencia
Valladolid
Zamora
Zaragoza
-- Not applicable --
I accept to receive information about Elsevier's special products and promotions by email
I accept to receive information about products and special promotions from Elsevier partners by email
I have read and understand the Privacy Policy and Terms and conditions and agree to be bound by all of its terms.
* Required fields
In addition to temporary access to the article, it will be sent by email.
Customer Support
Phone
Calls from Spain
932 415 960
Calls from abroad
+34 932 415 960
Hours from 9 a.m. to 6 p.m. except the months of July and August, which will be from 9 am to 3 pm.
Idiomas
Revista Clínica Española (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?