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Master Thesis

Évaluation de la mise en place d'un protocole de soins « Urgence Thrombose » au CHU Timone

Abstract : Objective: Describe the use of diagnostic, prognostic and therapeutic algorithms for venous thromboembolic disease (VTE), directly derived from recommendations, in the Timone Emergency Department and compare two groups: 2015 group "without care protocol" and 2017 group "with care protocol". Methods: Retrospective study of 141 patients admitted to the emergency department of CHU Timone in Marseille for VTE from January to June 2015 for the group 2015 and from January to June 2017 for the group 2017. The clinical characteristics of the patients, the episode of VTE and the hospital management were collated. Results: 79 patients were included in the 2015 group and 62 patients in the 2017 group. In 24% of cases a clinical probability score was calculated in the 2017 group (0 in the 2015 group p <0.001). There is no significant difference on the application of diagnostic algorithms (30.3% group 2015 vs 27.4% group 2017). In none of the groups studied, the severity score sPESI was noted in the record. All patients with pulmonary embolism were hospitalized regardless of the sPESI score. 36% of patients admitted for DVT were hospitalized in the 2015 group while for the 2017 group the management was only ambulatory. 52.5% of patients were treated with AOD in the 2017 group against 32.5% in the 2015 group (p = 0.018). In 18% of cases, a DOA was prescribed by the emergency physicians in the 2017 group against 2.5% in the 2015 group (p = 0.002). Mean hospital stay was 7.4 days in the 2017 group and 9.4 days in the 2015 group (p = 0.03). Conclusion: We show an improvement in the computation of the clinical probability score, an increase in the outpatient management of DVT, an increase in the prescription of DOA and a reduction in the length of hospital stay. The integration of computationally and computationally computed clinical and prognostic probability scores would optimize this course, as well as a better dissemination of the post-emergency consultation created for outpatients.
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Submitted on : Monday, October 29, 2018 - 4:09:58 PM
Last modification on : Monday, July 6, 2020 - 4:46:58 PM
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Abira El Yaagoubi. Évaluation de la mise en place d'un protocole de soins « Urgence Thrombose » au CHU Timone. Sciences du Vivant [q-bio]. 2017. ⟨dumas-01907908⟩