scholarly journals Endogenous fibrinolysis—Relevance to clinical thrombosis risk assessment

2020 ◽  
Author(s):  
Rahim Kanji ◽  
Jacek Kubica ◽  
Eliano P. Navarese ◽  
Diana A. Gorog
Keyword(s):  
Risk Assessment ◽  
Thrombosis Risk ◽  
Endogenous Fibrinolysis

Thrombosis Risk Assessment as a Guide to Quality Patient Care

2005 ◽  
Vol 51 (2-3) ◽  
pp. 70-78 ◽  
Author(s):  
Joseph A. Caprini
Keyword(s):  
Risk Assessment ◽  
Patient Care ◽  
Quality Patient Care ◽  
Thrombosis Risk

scholarly journals Thrombosis Risk Assessment In The COVID-19 Era

2020 ◽  
Vol 10 (3) ◽  
pp. 1-2
Author(s):  
Joseph A Caprini
Keyword(s):  
Risk Assessment ◽  
Preventive Measures ◽  
Quality Data ◽  
High Quality Data ◽  
Thrombosis Risk ◽  
Anticoagulant Drugs ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Risk Scoring ◽  
Anticoagulant Prophylaxis

The appearance of the coronavirus pandemic has prompted a renewed interest in thrombosis risk assessment, particularly since this disease is associated with a high risk of thrombotic events. It is known that the number one preventable cause of death in hospitalized patients including those having surgical procedures is fatal pulmonary emboli. There is also high-quality data that the use of anticoagulant drugs in the proper dose, and for the period of time shown to be efficacious, will prevent most fatal events. It is true that even with the use of the best anticoagulant regimes venous thromboembolic events (VTE) can still occur but are rarely fatal. We also realize that providing adequate anticoagulant prophylaxis for the entire period of risk is the key to preventing these deaths.  Thrombosis risk scoring identifies who's at risk for these emboli and guides physician choices for appropriate preventive measures.

REVIEW: Stent Thrombosis-Risk Assessment and Prevention

2010 ◽  
Vol 28 (5) ◽  
pp. e92-e100 ◽  
Author(s):  
Zuzana Motovska ◽  
Jiri Knot ◽  
Petr Widimsky
Keyword(s):  
Risk Assessment ◽  
Stent Thrombosis ◽  
Thrombosis Risk ◽  
Risk Assessment And Prevention

It is time to change thrombosis risk assessment for PV and ET?

2014 ◽  
Vol 27 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Francesco Passamonti ◽  
Domenica Caramazza ◽  
Barbara Mora ◽  
Rosario Casalone ◽  
Margherita Maffioli
Keyword(s):  
Risk Assessment ◽  
Thrombosis Risk

scholarly journals Development and Baseline Characterization of a Thrombosis Risk Alert Tool: A Quality Assessment Project

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 18-19
Author(s):  
Claire M Sathe ◽  
Chester Poon ◽  
Debra M. M Sarasohn ◽  
Leah Gilbert ◽  
Alok A Khorana ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Hodgkin Lymphoma ◽  
Research Funding ◽  
Biliary Tract Cancers ◽  
Non Hodgkin Lymphoma ◽  
Thrombosis Risk ◽  
Increased Risk ◽  
Cancer Associated Thrombosis ◽  
Prophylactic Anticoagulation

Introduction: The Khorana Score (KS) is a validated tool to assess the risk of thrombosis in cancer patients, prior to initiation of chemotherapy. The AVERT and CASSINI studies evaluated prophylactic anticoagulation with apixaban or rivaroxaban for patients with KS of 2 or higher. Both studies demonstrated that while patients were taking prophylactic anticoagulant, the Hazard Ratio of cancer associated thrombosis was approximately 0.4. The NCCN and other societies are now recommending oral anticoagulant prophylaxis should be considered for up to 6 months, for patients with an intermediate or high-risk score of ≥2. Methods: We have developed a medical record tool, that identifies all MSKCC patients prior to initiation of a new chemotherapy regimen, captures the KS parameters, and generates the KS. Once fully implemented, it is anticipated that this tool and appropriate use of prophylactic anticoagulation, will reduce the burden of cancer associated thrombosis. To accurately document a potential reduction in rates of cancer associated thrombosis, we need to establish current baseline rates of cancer associated thrombosis via a contemporary verification of the KS, reflecting potential changes in oncology in the 12 years since the score was first published. We applied our KS capture tool to a 2-year period (10/17/2017 to 11/29/2019). 13,992 patients were identified with a new chemotherapy order, of whom 13,176 were found to have cancer and had complete parameters for the KS. We tracked all patients for 6 months, to identify possible episodes of Venous Thromboembolism (VTE). VTE episodes were identified by capturing the impressions of all contrast imaging studies, Doppler ultrasounds, and V/Q scans, combined with keyword and phrase computer identification, and manual review. To identify possible VTE events that occurred at an outside emergency department or hospital, we also queried new prescriptions for therapeutic doses of anticoagulants and ICD10 codes. In this analysis we focus on deep vein thrombosis (DVT) and pulmonary embolism (PE). Results: The 6-month rate of VTE (DVT or PE) was 6.4%. The VTE rate was 4.1% in the KS 0 cohort, and >18% for patients with a score of 4 or greater. We assessed the contribution of each parameter of the KS, in univariate analysis. Of the cancers assigned 2 points in the KS, pancreatic cancer had the highest VTE rate of 13.7%, but gastric/esophageal cancer did not have an increased rate. Of the cancers assigned 1 point, germ cell/testis, gynecologic, and lung cancer, also had increased risk of VTE, but bladder and non-Hodgkin lymphoma did not. Renal/urothelial cancers and cholangiocarcinoma/biliary tract cancers were also associated with high rates of VTE, although were not assigned points using the KS. Elevated BMI (≥35 kg/m2) was a weak risk factor. However, baseline anemia (<10 gm/dL), leukocytosis (>11,000/mcL) and thrombocytosis (≥350,000/mcL) were all strong predictors of VTE rate. Conclusions: The purpose of this QA project was to provide contemporary data on baseline cancer associated thrombosis rates, anticipating implementation of a program of targeted primary thrombosis prophylaxis. It remains clear that the KS provides a valuable risk assessment tool, stratifying 6-month VTE risk from 4.1% to >18%. Cancer type is typically the parameter that gets the first consideration. And most of the cancers with 1 or 2 points did predict increased risk. We don't have an explanation as to why, gastric/esophageal cancers and non-Hodgkin lymphoma were not associated with increased risk, but this finding may reflect the stage of their treatment at which patients begin care at MSKCC. Renal/urothelial, and cholangiocarcinoma/biliary tract cancers are associated with a high risk of VTE, and one may choose to include them for consideration of prophylactic anticoagulation. The relative contribution of pre-chemotherapy blood counts has been questioned in the past, but in this cohort, they clearly contributed to appropriate risk assessment. These data will serve as baseline for future assessment of thrombosis risk reduction upon implementation of a program of targeted prophylactic anticoagulation. Table Disclosures Khorana: Leap: Research Funding; BMS: Honoraria, Research Funding; Merck: Research Funding; Array: Other: Research funding (to institution); Janssen: Honoraria; Bayer: Honoraria; Pfizer: Honoraria; Sanofi: Honoraria; Medscape: Honoraria; Leo Pharma: Honoraria; Seattle Genetics: Honoraria; Pharmacyte: Honoraria; Pharmacyclics: Honoraria. Mantha:MJH Associates: Honoraria; Physicians Education Resource: Honoraria. Soff:Amgen: Research Funding; Amgen: Honoraria; Janssen Scientific Affairs: Honoraria; Dova Pharmaceuticals: Honoraria; Bristol-Myers Squibb, Pfizer: Honoraria; Janssen Scientific Affairs: Research Funding; Dova Pharmaceuticals: Research Funding.

scholarly journals 37 Accuracy of Venous Thromboembolism Risk Assessments in The Trauma and Orthopaedics Wards of The Gloucestershire Royal Hospital

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
T Njim ◽  
A Hafez ◽  
I Omar
Keyword(s):  
Risk Assessment ◽  
Venous Thromboembolism ◽  
Clinical Guideline ◽  
Risk Groups ◽  
Lower Limbs ◽  
Risk Assessments ◽  
Royal Hospital ◽  
Vte Prophylaxis ◽  
Inflammatory Conditions ◽  
Thrombosis Risk

Abstract Introduction Venous thromboembolism (VTE) risk assessment is crucial for patients undergoing orthopaedic surgery. An accurate risk assessment leads to patient stratification into risk groups for appropriate VTE prophylaxis. Aim To evaluate the accuracy of VTE risk assessment in the orthopaedic wards of the Gloucestershire Royal Hospital (GRH). Method We used the drug charts available on the wards of GRH which follow the NICE Clinical guideline [CG92]. We identified four variables out of the 19 questions that assess thrombosis risk: age, BMI, presence of infection/inflammatory conditions and surgery to the lower limb. Drug charts from the 10th of November to the 15th of November 2020 were assessed for completeness and accuracy. The number and accuracy of drug charts with VTE risk assessments on admission and 24 hours after admission were assessed. Results Fifty-seven drug charts with VTE risk assessments were identified over this period. Only 66.7% of VTE risk assessments were complete on admission and 21.1% were complete 24 hours after admission. Accuracy of assessment on admission was 92.1%, 86.1%, 81.6% and 79.0% for age, BMI, categories of surgery to the lower limbs and presence of inflammation, respectively. Accuracy of assessment at 24 hours was 91.7%, 83.3%, 50.0% and 91.7% for age, BMI, surgery to the lower limbs and presence of infection/inflammation, respectively. Conclusions VTE risk assessment upon admission and at 24 hours is relatively low and needs improvement. A further enquiry is necessary to evaluate the reasons for defective VTE assessment.

A Comparative Approach to Deep Vein Thrombosis Risk Assessment

2006 ◽  
Vol 13 (1) ◽  
pp. 28-30 ◽  
Author(s):  
Wendy Hums ◽  
Paul Blostein
Keyword(s):  
Risk Assessment ◽  
Deep Vein Thrombosis ◽  
Comparative Approach ◽  
Vein Thrombosis ◽  
Thrombosis Risk ◽  
Deep Vein
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