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The LANCET Published ENDORSE, the Largest Multinational Study Showing That the Majority of Hospitalized Patients Surveyed are at Risk for VTE and Many do not Receive Recommended VTE Prophylaxis

Friday, February 1, 2008 General News J E 4
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WORCESTER, Massachusetts, February 1

- ENDORSE Global Findings Highlight the Need to Urgently ImplementHospital-Wide Strategies to Optimize VTE Management: Systematically AssessPatient Risk for VTE and Provide Appropriate Prophylaxis to Prevent VTE

ENDORSE multinational study (Epidemiologic International Day for theEvaluation of Patients at Risk for Venous Thromboembolism in the AcuteHospital Care Setting) published today in the LANCET(1) demonstrates the highprevalence of patients at risk for VTE (according to the ACCP guidelines) inthe world: 52% of hospitalized patients surveyed were at risk for VTE,corresponding to 64% of surgical patients and 42% of medical patients.

ENDORSE demonstrates as well, that recommended prophylaxis is onlyprescribed to 50% of at-risk patients throughout the world, corresponding to59% of surgical and 40% of medical patients.

With more than 60,000 patients studied in more than 32 countriesencompassing 6 continents the scope of ENDORSE is unprecedented. With a widerange of racial, social, economic and health care environment, ENDORSE givesa unique global and local picture about the extent of the hospitalizedpatient population at risk for VTE and how these patients are managed.

Doctor Fred Anderson, Director of the Center for Outcomes Research at theUniversity of Massachusetts Medical School who conducted the study commented"ENDORSE shows that a substantial proportion of hospitalized patients are atrisk for VTE in each of 32 participating countries. Despite these objectivedata that VTE risk is important on a global scale, the use of recommendedprophylaxis is sub-optimal. This is a complex problem, which will requiremultiple solutions, including local and national programs of education,guideline development, increased reimbursement for prophylaxis, and additionof VTE prevention to the health-care agenda in every country."

VTE is a major public health issue and easily preventable disease amongpatients hospitalized for acute medical and surgical illnesses. Deep veinthrombosis (DVT) and pulmonary embolism are common manifestations of VTE andcan contribute significantly to morbidity and mortality.

Commenting on the study, Doctor Ander Cohen, Co-chair of the ENDORSESteering Committee, said "ENDORSE findings are important from national heathcare perspectives since they allow estimation of both the patient welfare andeconomic benefits of fully applying evidence based VTE prophylaxis amonghospitalised medical and surgical patients. If we want to improve hospitalpatient outcomes, we urgently need to implement hospital-wide strategies toidentify all surgical and medical patients at risk for VTE and improve theuse of appropriate prophylaxis to prevent VTE."

Despite International and local guidelines on VTE management, ENDORSEresults illustrate clearly that there is a gap between guidelines evidenceand practice in the hospital setting throughout the world. Lack of awarenessand uncertainty about the prevalence of patients at risk of VTE are among themajor reasons accounting for this gap(2),(3)

As highlighted by Doctor Victor Tapson, Co-chair of the ENDORSE SteeringCommittee: "ENDORSE clearly shows that VTE is a critical safety issue inhospitalized patients, as the majority of them are at risk for VTE. Theincreased use of prophylaxis in the surgical setting for which the benefitsof prophylaxis have been accepted for many years compared with medicalsetting for which trials and guidelines are more recent, shows that we haveto increase physician awareness on the benefits of prophylaxis particularlyin medical patient."

About venous thromboembolism (VTE)

Venous thromboembolism is a general term used to describe the formationof a blood clot (thrombus) that blocks a vein. This may occur in any part ofthe venous system, but the most common manifestations are deep-veint
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