A computer programme alerts doctors to the risk of thrombosis

Doctors from the Navarre University Clinic [Clinica Universitaria de Navarra (CUN)] have developed an electronic alarm system that alerts doctors to the level of risk of thrombosis in hospitalised patients. The programme, which performs a daily evaluation of each hospitalised patient, is a way to solve the problem of the lack of preventive treatment.

'This system sets out a risk profile for venous thromboembolism in each patient and alerts the doctor as to whether he should apply preventive or prophylactic treatment,' Jose Antonio Paramo, co-author of the research and a doctor at the CUN, explains to SINC.

This system has been described in the Thrombosis and Haemostasis journal, and achieves this by collecting information from each patient admitted to the clinic. This involves 'their baseline disease, the drugs they are taking, their lifestyle such as smoking or obesity, and whether they are going to have surgery,' the researcher outlines. These variables form part of the Pretemed scale, a model that calculates the risk of venous thrombosis validated throughout Spain. Each of these factors is equivalent to a score that increases the likelihood of alert which, according to the expert, 'already exists because of the mere fact of being admitted to hospital.'

During the patient's stay in hospital, the system gradually calculates the risk of thrombosis according to the patient's progress, by performing a daily evaluation of the medical risk factors or whether the patient has had surgery.

'When the score is low, physical measures are applied initially, such as the use of elastic stockings or early mobilisation, but when the score is higher than 4, thrombosis must be avoided by administering low weight molecular heparin,' the doctor clarifies. 'It is not that the system imposes prophylactic treatment, but when a patient's score is high it alerts the doctor by sending a message, and he is the person who decides whether or not to apply preventive measures,' the doctor adds.

At the moment, when the specialist is faced with cases of thrombosis, the specialist only suspects their risk of thrombosis. 'In hospitals it is those who need surgical intervention (surgical patients) who are admitted to hospital and those who do not need it (medical patients),' explains the expert.

Although surgeons are more reliant on administering heparin, this occurs less frequently in medical patients.' This is serious because the medical patients admitted can suffer from cardiac insufficiency, acute infections or pulmonary de-compensation, factors that increase the danger of thrombosis, but in many cases the doctor is unaware of the thrombosis risk,' he points out. 'Reminders are not enough, because people forget with the passage of time, but this alert system makes it a permanent reminder,' Paramo insists.

By using this electronic system, the incidence of thrombosis has been reduced by 40% and the use of low weight molecular heparin has increased in between 30 and 60% of patients. For this reason Paramo emphasises the need to make this more widespread in hospitals. 'This tool is not a patent, for which reason each centre must adapt it to its own IT system with the idea of setting up the same protocol,' the researcher points out.