Thromboprophylaxis in patients receiving inpatient palliative care: a survey of present practice in Austria

Support Care Cancer. 2012 Sep;20(9):2183-7. doi: 10.1007/s00520-011-1330-6. Epub 2011 Nov 26.

Abstract

Background: There is limited data on the use of thromboprophylaxis in patients with advanced cancer. We therefore aimed to study the practice of thromboprophylaxis in palliative care units in Austria.

Methods: We monitored use, indication, and contraindications to thromboprophylaxis in 134 patients hospitalized in 21 palliative care units in a prospective, cross-sectional study.

Results: Forty-seven percent of patients were on low molecular weight heparin on the day of the study for primary or secondary thromboembolism. Thromboprophylaxis had been withdrawn in 18% of the patients upon admission to the palliative care unit. Contraindications for thromboprophylaxis were present in 27% of all patients. Cancer was present in 86% of the patients. The use of thromboprophylaxis was similar in cancer patients and in non-cancer patients (49% vs. 42%). Contraindications for thromboprophylaxis were present in 24% of all cancer patients. Significantly more bedridden cancer patients had contraindications for prophylaxis when compared with mobile cancer patients (35% vs. 16%; p = 0.03). Low performance status was by far the most frequent contraindication among these patients (89%). Seventy-one percent of all bedridden cancer patients were treated in accordance with common guidelines for thromboprophylaxis when contraindications were taken into account. Eighty-seven percent of patients who had been involved in decision making opted for getting prophylaxis.

Conclusions: Our data reveal that about half of all cancer patients in palliative care units are treated with thromboprophylaxis. Low performance status was the most frequent contraindication for thromboprophylaxis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Austria
  • Female
  • Hospitalization
  • Humans
  • Male
  • Palliative Care*
  • Practice Guidelines as Topic
  • Prospective Studies
  • Surveys and Questionnaires
  • Thrombosis / prevention & control*