Implementation of antithrombotic management in atrial fibrillation
| Autor: | K J Hardy, D Hutchinson, S J McNulty |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Clinical audit
medicine.medical_specialty business.industry Warfarin Management of atrial fibrillation Atrial fibrillation Original Articles General Medicine medicine.disease Antithrombotic Emergency medicine medicine Physical therapy cardiovascular diseases Risk factor Risk assessment business Stroke medicine.drug |
| Zdroj: | Postgraduate Medical Journal. 76:783-786 |
| ISSN: | 1469-0756 0032-5473 |
| DOI: | 10.1136/pgmj.76.902.783 |
| Popis: | The aim of the study was to assess the extent to which published recommendations on the antithrombotic management of atrial fibrillation had been adopted into clinical practice in a busy district general hospital, and the impact of clinical audit on subsequent management. In the initial audit, 185 consecutive patients with atrial fibrillation were studied using their case notes to identify any further clinical risk factors for stroke. A management algorithm stratified patients with atrial fibrillation into high, moderate, or low risk of stroke according to the individual stroke risk factors. For patients at high risk, the correct treatment is warfarin unless there are specific contraindications. For patients at moderate risk, the correct management is aspirin unless there are specific contraindications. Patients at low risk should receive no thromboprophylaxis. The clinical risks of stroke and thromboprophylaxis on discharge from hospital were recorded. An extensive education programme on stroke prevention in atrial fibrillation was undertaken. Six months later a further 185 consecutive patients with atrial fibrillation were audited. Overall, a large proportion (306/370; 83%) of patients were at high risk of stroke. In the initial audit, antithrombotic management was correct in 89 patients (48%). In the follow up audit, antithrombotic management was correct in 135 patients (73%) (p |
| Databáze: | OpenAIRE |
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