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Use of Thromboprophylaxis in Palliative Care Patients: A Survey Among Experts in Palliative Care, Oncology, Intensive Care, and Anticoagulation
Katharina A. Kierner, MD,
Verena Gartner, MD,
Maria Schwarz, MD,
and
Herbert H. Watzke, MD*
From the Unit of Palliative Care, Department of Medicine I, Medical University of Vienna, Austria
* To whom correspondence should be addressed. E-mail: herbert.watzke{at}meduniwien.ac.at.
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Abstract |
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Study-based guidelines on thromboprophylaxis are not available for palliative care patients. The authors asked a panel of academic medical experts in palliative care, oncology, blood coagulation, and intensive care to select a prophylactic regimen out of 5 predefined options for a virtual patient with advanced bronchial cancer in different clinical settings. Primary prophylaxis for venous thromboembolism was withdrawn by all physicians when the patient had a Karnovsky’s index of 10 and was described as dying. It was given by 25% of physicians when the patient had a Karnovsky’s index of 20 and by 85% when Karnovsky’s index 40 was still 40. Similar results were obtained in the situation of secondary prophylaxis of venous thromboembolism and when the patient was described as having a history of chronic atrial fibrillation. This data clearly show that thromboprophylaxis is delivered according to a compound estimate of risks and benefits of such prophylaxis in a specific palliative care situation.
First published on January 15, 2008, doi:10.1177/1049909107310142
American Journal of Hospice and Palliative Medicine® 2008;25:127.
A more recent version of this article appeared on May 1, 2008
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