scholarly journals Comparison of hospital length of stay in patients treated with non–vitamin K oral anticoagulants or parenteral agents plus warfarin for venous thromboembolism

2017 ◽  
Vol 5 ◽  
pp. 205031211771962 ◽  
Author(s):  
Catherine A Saint ◽  
Michelle R Castelli ◽  
Andrew J Crannage ◽  
Zachary A Stacy ◽  
Erin K Hennessey
Keyword(s):  
Venous Thromboembolism ◽  
Length Of Stay ◽  
Vitamin K ◽  
Oral Anticoagulants ◽  
Hospital Length ◽  
Hospital Length Of Stay

scholarly journals Reversal of warfarin anticoagulation in geriatric traumatic brain injury due to ground-level falls

2019 ◽  
Vol 4 (1) ◽  
pp. e000352
Author(s):  
Michael John Paisley ◽  
Arianne Johnson ◽  
Spencer Price ◽  
Bernard Chow ◽  
Liliana Limon ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Vitamin K ◽  
Geriatric Patients ◽  
Oral Anticoagulants ◽  
Ground Level ◽  
International Normalized Ratio ◽  
Fresh Frozen Plasma ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Level Of Evidence

BackgroundThe efficacy of prothrombin complex concentrate (PCC) compared with fresh frozen plasma (FFP) for reversal of oral anticoagulants has not been investigated in geriatric patients suffering intracranial hemorrhage (ICH) due to a ground-level fall (GLF).MethodsPatients 65 years and older who were treated at Santa Barbara Cottage Hospital between January 2011 and March 2018 with ICH after a GLF while taking warfarin were reviewed. Patients were reversed with either FFP (n=25) or PCC (n=27) and patient outcomes were compared. Separate analyses were conducted for patients who received adjuvant vitamin K administration and those who did not.ResultsMortality rates, hospital length of stay, intensive care unit admission and length of stay were similar for both FFP and PCC intervention. There was no difference in radiological progression of hemorrhage within the first 24 hours of admission (FFP: 36%, PCC: 43%, p=0.365). In patients who had international normalized ratio (INR) values measured prior to intervention, 81% (17 out of 21) of the PCC group reached an INR value below 1.5 within an 8-hour period, whereas only 29% (4 out of 14) of the FFP group did (p=0.002). Vitamin K was concomitantly given to 28% of the patients receiving FFP, and 81% of those patients receiving PCC. No significant differences in outcomes were found whether adjunctive vitamin K was administered or not, in either FFP or PCC group. However, when vitamin K was not administered, the PCC group had a higher rate of INR reversal (80% vs. 10% for FFP, p=0.006).ConclusionAdministration of PCC is as effective in short-term outcomes as FFP in treating geriatric patients on warfarin sustaining an ICH after a GLF. INR reversal was more successful, significantly faster, and required lower infusion volumes in patients receiving PCC.Level of evidenceLevel III.

scholarly journals Development and Validation of Postoperative Venous Thromboembolism risk prediction model

2020 ◽  
Author(s):  
Sang H. Woo ◽  
Ruben Rhoades ◽  
Lily Ackermann ◽  
Scott W. Cowan ◽  
Jillian Zavodnick ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Length Of Stay ◽  
Prediction Model ◽  
Risk Prediction ◽  
Hospital Length ◽  
Risk Prediction Model ◽  
Hospital Length Of Stay ◽  
Improvement Program ◽  
Acs Nsqip ◽  
Using Data

AbstractBackgroundVTE is a serious postoperative complication after surgery with resultant higher morbidity and mortality. Despite years of experience with current risk models, rates continue to be high and more information is needed on individual patient risk in the prophylaxis era.Research QuestionsCan we assess the individualized risk of postoperative venous thromboembolism (VTE) for broad categories of surgery?MethodsThis study was performed using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Database. Patient data (n=2,875,190) from 2015-2017 were used for study analysis. Eight predictors were selected for the model: age, preoperative platelet count≥450 (×109/L), disseminated cancer, corticosteroid use, serum albumin ≤2.5 g/dL, preoperative sepsis, hospital length of stay and surgery type. The second model included 7 predictors without hospital length of stay. A predictive model was trained using ACS-NSQIP data from 2015-2016 (n=1,859,227) and tested using data from 2017 (n= 1,015,963). Primary outcomes are postoperative 30-day VTE, including deep vein thrombosis (DVT) and/or pulmonary embolism (PE).ResultsVTE occurred in 23,249 patients (0.81%) and 49.9% of VTE occurred after discharge from index hospitalization. The risk prediction model had high AUC (area under the receiver operating characteristic curve) for postoperative VTE of 0.78 (training cohort) and 0.78 (test cohort).InterpretationThis clinical prediction model is a validated, practical and easy-to-use tool to identify surgical patients at the highest risk of postoperative VTE and provide an individualized assessment of risk based on clinical factors and type of surgery. This prediction model may be used as a tool to assess individualized risk of postoperative VTE and promote broader discussion and awareness of the VTE risk during the perioperative period.

Abstract 155: Elevated Risk of Venous Thromboembolism in Patients Undergoing Targeted Temperature Management After Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Toishi Sharma ◽  
Jordan Kunkes ◽  
Waleed Ibrahim ◽  
David O Sullivan ◽  
Antonio B Fernandez
Keyword(s):  
Cardiac Arrest ◽  
Venous Thromboembolism ◽  
Length Of Stay ◽  
Therapeutic Hypothermia ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Temperature Management ◽  
Control Group ◽  
Study Group ◽  
Endovascular Cooling

Introduction: Therapeutic hypothermia (TH) reduces mortality and improves neurological outcomes after cardiac arrest. Cardiac arrest is considered a pro-thrombotic state. Endovascular cooling catheters may increase the risk of thrombosis. Therapeutic hypothermia (TH), however, increases fibrinolysis. These opposing effects may expose patients to both bleeding and venous thromboembolic risk during and after therapeutic hypothermia. The net effect in these patientsremains largely unexplored. Moreover, the exact rate of venous thromboembolism (VTE) is uncertain in these patients. We sought to determine the incidence and potential predictors of VTE in patients undergoing TH after cardiac arrest and compare it to a control group with similar risk of VTE. Methods: Single center retrospective analysis. Participants were age ≥18 years old, admitted to Hartford Hospital with out-of-hospital or in-hospital cardiac arrest, underwent TH between January 1, 2007 and April 30, 2019 with endovascular cooling catheter. A total of 562 patients who underwent TH (Study group) were compared to 304 matchedpatientstreated in the medical ICU with a diagnosis of ARDS (control group). This control group was based on presumed similarities in factors affecting VTE: intensive care setting, immobility, length of stay and likely presence of central venous catheters. Results: Patients who underwent TH had a significantly higher rate of VTE (6.6% vs 4.6%, p=0.006) and deep vein thrombosis (DVT) (2.3% vs 1.3%, p=0.011) when compared to control group. The rate of pulmonary embolism was higher in the TH group, but this was not statistically significant (2.5% and 1.0%, p=0.128). In multivariate analysis age, gender, race and hospital length of stay were not associated with development of VTE in the study group. Conclusion: Patients undergoing TH after cardiac arrest have statistically higher incidence of VTE and DVT compared to patients with ARDS. This risk is independent of age, gender, race or length of stay. Further research into additional independent predictors of VTE and DVT in this population may eventually guide the management and potential future interventions.

scholarly journals PCV59 HOSPITAL LENGTH OF STAY AMONG VENOUS THROMBOEMBOLISM PATIENTS TREATED WITH APIXABAN AND WARFARIN IN ENGLAND

2019 ◽  
Vol 22 ◽  
pp. S552
Author(s):  
R. Carroll ◽  
D. Lambrelli ◽  
R. Donaldson ◽  
S. Ramagopalan ◽  
R. Alikhan
Keyword(s):  
Venous Thromboembolism ◽  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay
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