WORCESTER, Massachusetts, July 8 /PRNewswire/ --

- ENDORSE Global Findings Highlight the Need to Urgently Implement 
Hospital-Wide Strategies to Optimize VTE Management: Systematically Assess 
Patient Risk for VTE and Provide Appropriate prophylaxis to Prevent VTE

Venous thromboembolism (VTE) risk is high among hospital
patients and most of these at-risk patients are not protected with adequate
prophylaxis according to data from the international ENDORSE (Epidemiologic
International Day for the Evaluation of Patients at Risk for Venous
Thromboembolism in the Acute Hospital Care Setting) study presented today at
the XXIst International Society on Thrombosis and Haemostasis (ISTH) congress
in Geneva.

VTE is a preventable disease which contributes significantly
to morbidity and mortality among patients hospitalized for acute medical and
surgical illnesses. Many complications and deaths due to VTE could be
prevented using thromboprophylaxis as recommended by evidence based
guidelines, but some studies have shown that there is a gap between evidence
and practice in the hospital setting. Lack of awareness and uncertainty about
the prevalence of patients at risk for VTE are among the major reasons
accounting for this gap (1, 2). To date, there has been no large
international study performed in hospitals selected at random around the
world to evaluate VTE risk and prophylaxis practice globally.

ENDORSE collected data on more than 60,000 patients who were
surveyed across 358 acute care hospitals randomly selected in 32 countries,
encompassing 5 continents. All participating hospitals followed the same
standard multinational protocol to survey the patients present in the wards.

The main objectives of ENDORSE were to assess the prevalence
of VTE risk in the acute hospital care setting and to determine the
proportion of at-risk patients who receive recommended prophylaxis using the
definition of patients at risk of VTE and prophylaxis recommendations
provided by the American College of Chest Physicians (ACCP) evidence-based
consensus guidelines (3). The study included two categories of hospitalized
patients: patients in medical wards 40 years of age or older, and patients in
surgical wards, 18 years or older.

Doctor Fred Anderson, Director of the Center for Outcomes
Research at the University of Massachusetts Medical School who conducted the
study commented "ENDORSE is the first study to provide a global view of VTE
risk and prophylaxis practices throughout the world. With more than 60,000
patients studied in more than 30 countries, the scope of ENDORSE is
unprecedented. In view of the quality of the data collected and a common
method to assess patients at risk for VTE and prophylaxis used, this study
gives us a unique picture both globally and locally about the extent of the
hospitalized patient population at risk for VTE and how these patients are
managed."

ENDORSE demonstrates the high prevalence of patients at risk
for VTE: 52% of hospitalized patients surveyed were at risk for VTE,
corresponding to 64% of surgical patients and 42% of medical patients. The
prevalence of patients at risk was consistent across the countries surveyed,
demonstrating the importance of VTE risk on a global scale.

Importantly, when considering the use of recommended
prophylaxis in hospitals, only 50% of hospitalized patients at risk for VTE
received a method of prophylaxis recommended by the ACCP, corresponding to
59% of surgical and 40% of medical patients at risk for VTE. The use of
recommended prophylaxis varied across countries; however, it was globally
sub-optimal and even more so in medical than surgical patients, as the
majority of medical patients at risk for VTE (60%) did not receive
recommended prophylaxis.

As highlighted by Doctor Victor Tapson, Co-chair of the
ENDORSE Steering Committee: "ENDORSE clearly shows that VTE is a critical
safety issue in hospitalized patients, as the majority of them are at risk
for VTE. This is really a global concern as a high proportion of patients at
risk for VTE is observed across all the countries surveyed. Importantly,
ENDORSE showed that one out of 2 hospitalized patients at risk for VTE were
not receiving any recommended form of prophylaxis. It definitely shows that
there is globally a sub-optimal use of VTE prophylaxis and this is even more
pronounced among medically ill patients."

Commenting on the study, Doctor Ander Cohen, Co-chair of the
ENDORSE Steering Committee, said "ENDORSE findings provide strong evidence of
the need to increase awareness about the high prevalence of VTE risk among
hospitalised medical and surgical patients. Importantly, it highlights the
need to significantly improve the use of appropriate prophylaxis in patients
at risk for VTE. In the United States for instance, VTE prophylaxis has been
identified as the number #1 strategy to improve patient safety in the
hospital. If we want to improve hospital patient outcomes, we urgently need
to implement hospital-wide strategies to identify all surgical and medical
patients at risk for VTE and provide appropriate prophylaxis to prevent VTE."

About venous thromboembolism (VTE)

Venous thromboembolism is a general term used to describe the
formation of a blood clot (thrombus) that blocks a vein. This may occur in
any part of the venous system, but the most common manifestations are
deep-vein thrombosis (DVT), usually in the leg, and pulmonary embolism (PE).

VTE is a common complication among patients hospitalized for major
surgery or with a severe medical illness such as cancer or cardiopulmonary
disease, particularly when accompanied by prolonged bed rest, age over 60, or
a previous history of VTE.

About COR (Center for Outcomes Research)

The Center for Outcomes Research (COR) serves as the
scientific coordinating center for a growing number of national and
international outcomes registries. COR's responsibilities include maintaining
patient and physician confidentiality, design of data collection instruments,
data management and publication development.

Established in 1994, COR is an outgrowth of the Worcester Deep
Vein Thrombosis Study, a five-year NIH-supported program, which demonstrated
that physicians are more likely to improve patient management practices if
they are provided with valid data on their own practices and outcomes along
with regional and national benchmarks.

About the University of Massachusetts Medical School

The University of Massachusetts Medical School, one of the fastest
growing academic health centers in the country, has built a reputation as a
world-class research institution, consistently producing noteworthy advances
in clinical and basic research. The Medical School attracts more than US$174
million in research funding annually, 80 percent of which comes from federal
funding sources. For more information, visit www.umassmed.edu.

ENDORSE study funding

The Center for Outcomes Research (COR) at the University of Massachusetts
Medical School received an unrestricted grant from sanofi-aventis to support
this work.

References

1. Goldhaber SZ, Tapson VF. Am J Cardiol. 2004;93:259-62.

2. Anderson FA Jr, et al. Blood. 2003;102 [abstract 1146].

3. Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous
thromboembolism: the seventh ACCP conference on Antithrombotic and Thrombotic
Therapy. Chest. 2004;126:338S-400S.