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Implementation of the Maynard-Based Risk Assessment Model for Venous Thromboembolism Inpatient Prophylaxis: A

Belisa Marin Alves1,2, Raquel Pereira Vieira2, Larissa Luma Tomasi Febras2

  • 1Graduate Program in Pulmonary Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre 91501-970, RS, Brazil.

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An electronic tool for assessing venous thromboembolism (VTE) risk did not improve prophylaxis adequacy in hospitalized patients. The Maynard model underestimated high-risk cases, particularly in orthopedic surgery patients.

Keywords:
electronic toolmultifaceted interventionsprophylaxisrisk assessmentvenous thromboembolism

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Area of Science:

  • Clinical Medicine
  • Health Services Research
  • Preventive Medicine

Background:

  • Venous thromboembolism (VTE) is a significant threat to hospitalized patients.
  • Underutilization of VTE risk assessment and prophylaxis contributes to preventable events.
  • Effective implementation of VTE prophylaxis protocols is crucial for patient safety.

Purpose of the Study:

  • To assess the effectiveness of an electronic risk stratification tool combined with multifaceted interventions for VTE prophylaxis.
  • To evaluate the implementation of VTE prophylaxis protocols in adult clinical and surgical patients at Hospital Moinhos de Vento, Brazil.
  • To compare the Maynard risk assessment model with Padua and Caprini scores for VTE risk stratification.

Main Methods:

  • Prospective before-and-after hospital-based study (2017-2019) involving 772 patients.
  • Utilized an electronic tool based on the Maynard model for VTE risk stratification.
  • Compared electronic tool classifications with Padua and Caprini scores; assessed prophylaxis adequacy against institutional protocols.

Main Results:

  • The Maynard model classified 0.9% low, 76.4% intermediate, and 22.7% high VTE risk, with notable differences in orthopedic surgical patients.
  • Overall prophylaxis adequacy was 69.3% with no significant change between study phases.
  • Orthopedic surgical patients experienced a significant decrease in prophylaxis adequacy in the second phase (p=0.02).

Conclusions:

  • The Maynard model underestimated high-risk VTE classification compared to Padua and Caprini scores, especially in orthopedic surgical patients.
  • The electronic tool and multifaceted interventions did not enhance VTE prophylaxis adequacy.
  • Further refinement of risk assessment tools and implementation strategies is needed for VTE prevention.