Venous Thromboembolism in patients with COVID-19. A prevalent and a preventable complication of the pandemic

Venous thromboembolism is a common but largely preventable complication following surgery. However, fatal complications can occur as a result of pulmonary embolism following deep vein thrombosis. A structured risk assessment should be performed preoperatively in all surgical patients and thromboprophylaxis measures should be tailored according to patient- and procedure-related factors. These measures include anticoagulation with low molecular weight heparin and the use of mechanical compression devices.

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EP.FRI.835 5 Years, 4 F1s, 3 Registrars, 2 Pandemic Waves, 1 VTE audit: Half a decade of VTE prophylaxis on a surgical ward

British Journal of Surgery ◽

10.1093/bjs/znab312.124 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Helena Colling Sylvester ◽

Naim Slim ◽

Michael Okocha

Keyword(s):

Venous Thromboembolism ◽

Hospital Admission ◽

Vte Prophylaxis ◽

The Third ◽

Surgical Ward ◽

Fourth Cycle ◽

Assessment Unit ◽

Prescribing Practice ◽

Electronic Prescriptions ◽

Preventable Complication

Abstract Aim Venous thromboembolism(VTE) is a preventable complication of hospital admission. This audit aims to compare VTE prophylaxis over 5 years in one surgical assessment unit and identify areas for improvement. Methods This was a snapshot, 5-cycle audit of the analysis of VTE risk, prescribing practice and prophylactic therapies offered at admission. We prospectively reviewed notes of patients admitted under general surgery over a snapshot period annually. Data was compared to figures collected over four previous years. Induction VTE prophylaxis teaching was introduced after the first cycle, HCA VTE champions were introduced after the second, digital reminders were introduced after the third, and monthly email reminders sent after the fourth cycle. Results VTE risk was documented for 92% of patients in 2017, 65% in 2018, 57% in 2019, 76% in 2020 and 53% in 2021. In the years 2017, 2018, 2019, 2020, 2021, Enoxaparin was prescribed for 96%, 68%, 75%, 55% and 73% of patients respectively. In 2017, 2018, 2019, 2020 and 2021, TED stockings were prescribed for 96%, 68%, 62%, 50% and 73% of patients respectively. Conclusions We utilised a multidisciplinary and digital approach against the issue of VTE prophylaxis on surgical wards. Despite best efforts, compliance was highly fluctuant with a drop during the first wave of the pandemic. This has demonstrated that with redistribution of regular nursing and medical staff, new patient filtering systems and increased healthcare pressures, previous mechanisms cannot be relied upon. We have began the process of electronic prescriptions with mandatory VTE prophylaxis checklists.

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Pulmonary embolism in a patient with neuroleptic malignant syndrome

Hematology Reports ◽

10.4081/hr.2018.7753 ◽

2018 ◽

Vol 10 (4) ◽

Cited By ~ 2

Author(s):

Mosaad Almegren

Keyword(s):

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Neuroleptic Malignant Syndrome ◽

Preventive Measures ◽

Early Mobilization ◽

Standard Of Care ◽

Antipsychotic Medications ◽

Rare Side Effect ◽

Low Threshold ◽

Preventable Complication

Venous thromboembolism is one of the complications in patients prescribed antipsychotic medications. Neuroleptic malignant syndrome (NMS) is a rare side effect of antipsychotic medications in this population. In this case, a young patient, who presented with NMS after a recent start of antipsychotic medications, had developed a pulmonary embolism despite standard of care measures of venous thromboprophylaxis and early mobilization. A low threshold of VTE suspicion and effective preventive measures are both required in order to avoid this preventable complication in this population.

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Survey of Perceptions and Practices among Canadian Gastroenterologists regarding the Prevention of Venous Thromboembolism for Hospitalized Inflammatory Bowel Disease Patients

Canadian Journal of Gastroenterology ◽

10.1155/2012/175249 ◽

2012 ◽

Vol 26 (11) ◽

pp. 795-798 ◽

Cited By ~ 12

Author(s):

Roshan Razik ◽

Charles N Bernstein ◽

Justina Sam ◽

Reka Thanabalan ◽

Geoffrey C Nguyen

Keyword(s):

Inflammatory Bowel Disease ◽

Venous Thromboembolism ◽

Bowel Disease ◽

Demographic Data ◽

Pharmacological Prophylaxis ◽

Vte Prophylaxis ◽

Clinical Scenarios ◽

Increased Risk ◽

Inflammatory Bowel ◽

Preventable Complication

BACKGROUND: Patients with inflammatory bowel disease (IBD) who are hospitalized with disease flares are known to be at an increased risk of venous thromboembolism (VTE). This is a preventable complication; however, there is currently no standardized approach to the prevention and management of VTE.OBJECTIVES: To characterize the opinions and general prophylaxis patterns of Canadian gastroenterologists and IBD experts.METHODS: A survey questionnaire was sent to Canadian gastroenterologists affiliated with a medical school or IBD referral centre. Participants were required to be practicing physicians who had completed all of their training and had been involved in the care of IBD patients within the previous 12 months. Various clinical scenarios were presented and demographic data were solicited.RESULTS: The majority of respondents were practicing in an academic setting (95%) and considered themselves to be IBD experts or subspecialists (71%). Eighty-three per cent reported providing VTE prophylaxis most, if not all of the time, and most (96%) used pharmacological prophylaxis alone, usually heparin or one of its analogues. There was less consistency among respondents with respect to whether IBD patients in remission, but admitted for another condition, should be given prophylaxis. There was also less agreement regarding the duration of anticoagulation in patients with confirmed VTE.CONCLUSION: There was a general consensus among academic gastroenterologists that IBD inpatients are at an increased risk for VTE and would benefit from VTE prophylaxis. However, areas of uncertainty still exist and the IBD community would benefit from evidence-based clinical practice guidelines to standardize the management of this important problem.

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