Combined assessment of thrombotic and haemorrhagic risk in acute medical patients

2016 ◽  
Vol 115 (02) ◽  
pp. 392-398 ◽  
Author(s):  
Francesco Orlandini ◽  
Francesca Marchini ◽  
Alessia Marinaro ◽  
Rosanna Bonacci ◽  
Paola Bonanni ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Multivariate Analysis ◽  
High Risk ◽  
Bleeding Complications ◽  
Thromboembolic Events ◽  
Medical Patients ◽  
Pharmacological Prophylaxis ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Supplementary Material

SummaryAcute medical patients have a high risk of venous thromboembolic events (VTE). Unfortunately, the fear of bleeding complications limits the use of antithrombotic prophylaxis in this setting. To stratify the VTE and haemorrhagic risk, two clinical scores (PADUA, IMPROVE) have recently been developed. However, it is not clear how many patients have a concomitant high VTE and haemorrhagic risk and what is the use of prophylaxis in this situation. To clarify these issues we performed a prospective cohort study enrolling consecutive patients admitted to internal medicine. Patients admitted to internal medicine (January to December 2013) were included. VTE and haemorrhagic risk were evaluated in all the included patients. Use and type of anti-thrombotic prophylaxis was recorded. A total of 1761 patients (mean age 77.6 years) were enrolled; 76.8 % (95 % CI 74.7–78.7) were at high VTE risk and 11.9 % (95 % CI 10.4–13.5) were at high haemorrhagic risk. Anti-thrombotic prophylaxis was used in 80.5 % of patients at high VTE risk and in 6.5 % at low VTE risk (p< 0.001), and in 16.6 % at high haemorrhagic risk and in 72.5 % at low haemorrhagic risk (p< 0.001). Prophylaxis was used in 20.4 % at both high VTE and haemorrhagic risk and in 88.9 % at high VTE risk but low haemor-rhagic risk. At multivariate-analysis, use of prophylaxis appeared highly influenced by the VTE risk (OR 68.2, 95 % CI 43.1 - 108.0). In conclusion, many patients admitted to internal medicine were at high risk of VTE. Since almost 90 % of them were at low haemorrhagic risk, pharmacological prophylaxis may be safely prescribed in most of these patients.Supplementary Material to this article is available online at www.thrombosis-online.com.

scholarly journals Bleeding complications after systematic switch of routine thromboprophylaxis for major orthopaedic surgery

2008 ◽  
Vol 99 (06) ◽  
pp. 1049-1052 ◽  
Author(s):  
Urs Kistler ◽  
Inès Quervain ◽  
Urs Munzinger ◽  
Nils Kucher
Keyword(s):  
Postoperative Bleeding ◽  
Bleeding Complications ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Major Orthopedic Surgery ◽  
Venous Thromboembolic ◽  
Major Orthopaedic Surgery ◽  
Orthopedic Patients ◽  
Second Period ◽  
Observation Period

SummaryThe rate of bleeding complications after major orthopedic surgery approximates 2%. It is unclear whether a systematic switch of routine thromboprophylaxis has an impact on the rate of postoperative bleeding complications. We analyzed prospectively recorded postoperative bleeding complications and symptomatic venous thromboembolic events in 8,176 consecutive orthopedic patients at the Schulthess Clinic Zurich during a systematic switch of thromboprophylaxis from nadroparin to enoxaparin in the year 2004. Overall, 3,893 patients received nadroparin in the first nine-month observation period before the switch and 4,283 patients received enoxaparin in the second nine-month observation period after the switch. Overall, 96 (2.5%) patients in the first period and 70 (1.6%) patients in the second period suffered a postoperative bleeding complication requiring surgical revision, puncture, or transfusion (p<0.01). Five objectively confirmed symptomatic venous thromboembolic events during hospitalization in the first period and three events in the second period were recorded. In conclusion, the switch of thromboprophylaxis in a large orthopedic clinic did not cause an increase of postoperative bleeding complications and therefore was accompanied by high patient safety.

Venous Thromboembolic Events After Spinal Fusion: Which Patients Are at High Risk?

2014 ◽  
Vol 96 (11) ◽  
pp. 936-942 ◽  
Author(s):  
Vadim Goz ◽  
Ian McCarthy ◽  
Jeffrey H Weinreb ◽  
Kai Dallas ◽  
John A Bendo ◽  
...  
Keyword(s):  
High Risk ◽  
Spinal Fusion ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

scholarly journals Predictors of Venous Thromboembolic Events Associated with Central Venous Port Insertion in Cancer Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Christine Hohl Moinat ◽  
Daniel Périard ◽  
Adrienne Grueber ◽  
Daniel Hayoz ◽  
Jean-Luc Magnin ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Venous Thrombosis ◽  
Cancer Patients ◽  
Thromboembolic Events ◽  
Central Venous ◽  
Central Venous Port ◽  
Venous Port ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

Insertion of central venous port (CVP) catheter in the cancer population is associated with increased incidence of venous thromboembolic events (VTE). However, trials have shown limited benefit of antithrombotic treatment to prevent catheter-related venous thrombosis. This prospective observational cohort study was designed to assess the incidence of VTE closely related to CVP implantation in patients with cancer and undergoing chemotherapy, and to identify a high risk subgroup of patients. Between February 2006 and December 2011, 1097 consecutive cancer patients with first CVP implantation were included. Catheter-related VTE were defined as deep venous thrombosis in the arm, with or without pulmonary embolism (PE), or isolated PE. The incidence of CVP-associated VTE was 5.9% (IC95 4.4–7.3%) at 3 months, and 11.3% (IC95 9.4–13.2%) at 12 months. The incidence of any VTE was 7.6% (IC95 6.0–9.3%) at 3 months, and 15.3% (IC95 13.1–17.6%) at 12 months. High Khorana risk score and lung cancer were significant predictors of 3 month VTE. In conclusion, this large cohort study of patients with first CVP catheter implantation confirms the high incidence of VTE associated with the CVP implantation and allow identifying high risk patients who may benefit from thromboprophylaxis.

Venous Thromboembolic Events in Spine Surgery Patients: Which Patients Are High Risk?

2013 ◽  
Vol 13 (9) ◽  
pp. S106
Author(s):  
Vadim Goz ◽  
Kai Dallas ◽  
Jeffrey H. Weinreb ◽  
John A. Bendo ◽  
Virginie Lafage ◽  
...  
Keyword(s):  
High Risk ◽  
Spine Surgery ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

scholarly journals Recurrence of Upper Extremity Deep Vein Thrombosis Secondary to COVID-19

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 878
Author(s):  
Yesha H. Parekh ◽  
Nicole J. Altomare ◽  
Erin P. McDonnell ◽  
Martin J. Blaser ◽  
Payal D. Parikh
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Extremity ◽  
Upper Extremity ◽  
Thromboembolic Events ◽  
Vein Thrombosis ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Deep Vein

Infection with SARS-CoV-2 leading to COVID-19 induces hyperinflammatory and hypercoagulable states, resulting in arterial and venous thromboembolic events. Deep vein thrombosis (DVT) has been well reported in COVID-19 patients. While most DVTs occur in a lower extremity, involvement of the upper extremity is uncommon. In this report, we describe the first reported patient with an upper extremity DVT recurrence secondary to COVID-19 infection.

Sign in / Sign up

Export Citation Format

Share Document