VTE Prophylaxis Across the Continuum of Care in US Medical Patients at Risk of Venous Thromboembolism.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1386-1386
Author(s):  
Alpesh Amin ◽  
Jay Lin ◽  
Amy Ryan
Keyword(s):  
At Risk ◽  
Research Funding ◽  
Medical Patients ◽  
Post Discharge ◽  
Vte Prophylaxis ◽  
Individual Patient Level ◽  
Patients At Risk ◽  
The Individual ◽  
Severe Lung Disease ◽  
The Continuum

Abstract Abstract 1386 Poster Board I-408 Background: Medical patients with chronic medical illnesses are often at risk of VTE both in-hospital and post-discharge. However, although injectable prophylaxis options are available and suitable for providing in-hospital and post-discharge prophylaxis, there is often a lack of continuity in VTE post-discharge prophylaxis. This analysis evaluated in-hospital and post-discharge VTE prophylaxis patterns for US medical patients. Methods: Premier's Perspective™ inpatient data were cross-matched at the individual patient level with Ingenix LabRx® outpatient data from the I3 database (January 2005-December 2007) to assess VTE prophylaxis patterns in medical patients (cancer without surgery, heart failure, severe lung disease, infectious disease) at risk of VTE (according to the American College of Chest Physicians 2004 guidelines) and with no contraindications for anticoagulation. Inpatients were assessed for any anticoagulation received in-hospital and were followed post-discharge to assess their outpatient prophylaxis use. Drug utilization and clinical practice patterns during and within 30 days after hospitalization were collected and compared descriptively between groups. Results: Of the 9,675 medical discharges at risk of VTE and included in this analysis, 6,185 (63.9%) did not receive any anticoagulation at all. Of the remaining 3,490 (36.1%) discharges that did receive anticoagulation, 2,045 (58.6%) received enoxaparin and 1,044 (29.9%) received unfractionated heparin (UFH) (Table). After discharge, 98.2% of all patients did not receive any prophylaxis within the following 30 days. Only 174 (1.8%) discharges received outpatient prophylaxis, with 67.8% receiving warfarin alone and 18.4% receiving enoxaparin and warfarin (Table). Conclusion: This analysis presents both inpatient and outpatient VTE prophylaxis patterns in real-world medical patients that are at risk of VTE. Nearly 64% of patients received no inpatient VTE prophylaxis, and less than 2% received outpatient prophylaxis. Further efforts to improve VTE prevention in hospitalized patients are required, with particular emphasis needed on the transition to outpatient prophylaxis. Disclosures: Amin: sanofi-aventis: Research Funding, Speakers Bureau, The authors received editorial/writing support in the preparation of this abstract funded by sanofi-aventis U.S., Inc.. Lin: sanofi-aventis: Employment. Ryan: sanofi-aventis: Research Funding.

VTE Prophylaxis Across the Continuum of Care in US Orthopedic Surgery Patients.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2097-2097
Author(s):  
Alpesh Amin ◽  
Jay Lin ◽  
Amy Ryan
Keyword(s):  
At Risk ◽  
Orthopedic Surgery ◽  
Research Funding ◽  
Significant Risk ◽  
Post Discharge ◽  
Vte Prophylaxis ◽  
Individual Patient Level ◽  
Hip Fracture Surgery ◽  
Major Orthopedic Surgery ◽  
Patients At Risk

Abstract Abstract 2097 Poster Board II-74 Background: Patients who undergo major orthopedic surgery are at significant risk of developing VTE. As 40-60% of orthopedic surgery patients develop VTE in the absence of thromboprophylaxis, evidence-based guidelines recommend pharmacological VTE prophylaxis in all patients without contraindications. As the risk of VTE persists beyond discharge in these patients, the use of LMWH and warfarin post-discharge is both suitable and recommended. However, a lack of awareness and education often leads to an absence of VTE prophylaxis post-discharge. This analysis evaluated in-hospital and post-discharge VTE prophylaxis patterns for US orthopedic surgery patients. Methods: Premier's Perspective” inpatient data were cross-matched at the individual patient level with Ingenix LabRx® outpatient data from the I3 database (January 2005-December 2007) to assess VTE prophylaxis patterns in major orthopedic surgery (total knee arthroplasty, total hip arthroplasty, hip fracture surgery) patients at risk of VTE (according to the American College of Chest Physicians 2004 guidelines) and with no contraindications for anticoagulation. Inpatients were assessed for the anticoagulant received in-hospital and were followed post-discharge to assess their outpatient prophylaxis use. Drug utilization and clinical practice patterns during and within 30 days after hospitalization were collected and compared descriptively between groups. Results: Of the 3,311 orthopedic surgery discharges at risk of VTE and included in this analysis, only 295 (8.9%) did not receive any anticoagulation at all. Of the remaining 3,016 (91.1%) discharges that did receive anticoagulation, 1,061 (35.2%) received enoxaparin, 1,028 (34.1%) received warfarin, and the remaining 927 (30.7%) received other or combination prophylaxis. However, after discharge only 1,800 (54.4%) of all patients received prophylaxis, with the majority receiving warfarin (1,028, 57.1%). The remaining 1,511 (45.6%) received no outpatient prophylaxis (Table). Conclusion: This analysis presents both inpatient and outpatient VTE prophylaxis patterns in real-world orthopedic surgery patients that are at risk of VTE. Although the rate of prophylaxis was high in inpatients, approximately half of all patients had no prophylaxis post-discharge. Further efforts to improve VTE prevention in discharged orthopedic surgery patients are required. Disclosures: Amin: sanofi-aventis: Research Funding, Speakers Bureau, The authors received editorial/writing support in the preparation of this abstract funded by sanofi-aventis U.S., Inc. . Lin:sanofi-aventis: Employment. Ryan:sanofi-aventis: Research Funding.

Defining the Risk: Benefit Ratio of Venous Thromboembolism (VTE) Prophylaxis in Hospitalized Cancer Patients

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 627-627 ◽  
Author(s):  
Dana E Angelini ◽  
Todd Greene ◽  
Julie N Wietzke ◽  
Scott A Flanders ◽  
Suman L. Sood
Keyword(s):  
Platelet Count ◽  
High Risk ◽  
Cancer Patients ◽  
Research Funding ◽  
Hospital Medicine ◽  
General Medicine ◽  
Number Needed To Treat ◽  
Medical Patients ◽  
Post Discharge ◽  
Vte Prophylaxis

Abstract Introduction: VTE affects 1.6-1.8/1000 hospitalized patients per year; active cancer increases the rate of VTE 6-fold. Despite the high risk of VTE, studies show cancer patients receive inpatient VTE prophylaxis at a lower rate than general medical patients. In addition, VTE prophylaxis is often held for a platelet value of <50x109/L, despite a lack of evidence. Current recommendations for all inpatients with cancer (and no contraindication to blood thinners) are to receive prophylactic anticoagulation, regardless of an increased bleeding tendency in this population. A formal risk:benefit ratio of inpatient VTE prophylaxis for cancer patients has not been evaluated to date. Methods: The Michigan Hospital Medicine Safety Consortium, a 49 hospital quality collaborative, has prospectively collected data on VTE risk factors and outcomes in medical patients > 18 years of age. Exclusion criteria include surgical patients, pregnancy, admission to the ICU or for palliative care, therapeutic anticoagulation, diagnosis of acute thrombus, history of VTE within 6 months, and length of stay < 2 days. We compared rates of VTE prophylaxis, bleeding and new VTE between cancer and general medicine patients who were eligible for prophylaxis (i.e. no contraindications including active bleed within 3 months, coagulopathy, or high risk brain metastasis). Student's t-test was used for continuous variables and chi-square for categorical data. Logistic regression was used to calculate odds ratio (OR). The number needed to treat and number needed to harm were used to derive a risk:benefit ratio. Results: Between 7/2012-7/2015, 86,634 admissions were captured in the cohort; 70,086 were eligible for VTE prophylaxis and included in this analysis. 22% of cases had a diagnosis of cancer. Table 1. Demographics on Admission Cancer (n= 15,166), % General Medicine (n=54,920), % p Race (Caucasian) 82.3 74.3 <0.001 Age mean yrs (SD) 72.5 (14.4) 63.7 (18.8) <0.001 Gender (female) 53.6 56.5 <0.001 Central Line 17.8 4.1 <0.001 History of VTE 7.6 5.3 <0.001 Caprini risk score ≥ 5 88.1 35.8 <0.001 Charleston Index mean (SD) 5.1 (2.5) 2.1 (2.0) <0.001 Ever Smoked 59.6 56.3 <0.001 Obese 29.3 37.1 <0.001 Surgery w/in 30 days 3.6 2.1 <0.001 Trauma w/in 30 days 0.3 0.4 0.01 Of cancer admissions, 89.5% had solid tumors, 13.5% hematologic malignancies, 3.4% both and 20% metastatic disease. Active treatment for cancer was delivered <6 months from index admission in 32.1%, within 6-12 mo in 3.2%, >12 mo in 44.4% and no treatment or unknown in 20.3%. When compared to general medical admissions, cancer admissions were more likely to receive VTE prophylaxis (72.16% vs 69.21%, p<0.001), and have a new VTE out to 90 days post discharge despite prophylaxis (0.91% vs 0.45%, p<0.001, unadjusted OR 2.07 (95% CI 1.6-2.7)). There was no difference in VTE rate with regard to platelet count in cancer cases (0.43% for plt < 50 vs 1.08% for plt ≥ 50, p=0.10). Among all patients receiving VTE prophylaxis, bleeding was more common in cancer cases (major bleeding 0.84% vs 0.58%, p=0.005; minor bleeding 1.80% vs 1.36%, p=0.002). Among cancer cases, bleeding rates were higher in patients with platelet <50 vs ≥ 50 (major bleed 4.86% vs 1.88%, p<0.001; minor bleed 2.88% vs 1.7%, p=0.04). Table 2. The Number Needed to Treat (NNT) to Prevent One VTE During Admission or 90 Days Post Discharge and Number Needed to Harm (NNH) to Cause One Major Bleed During Admission with Risk:Benefit Ratio (NNH:NNT) General Medicine Cancer NNT 1428 NNT 1000 NNH 2500 NNH 277.9 NNH:NNT 1.75 NNH:NNT 0.28 Conclusions: In this prospective inpatient cohort, we compared general medicine to cancer cases and found cancer admissions received VTE prophylaxis at a higher rate. This is different than previously reported data, likely due to the exclusion of patients with contraindications to prophylaxis. However, despite prophylaxis, cancer patients had a higher rate of VTE during admission and 90 days post discharge as well as more bleeding complications. The risk:benefit ratio of VTE prophylaxis is 6 times worse in cancer patients due to bleeding. While bleeding occurs more frequently in cancer patients with platelet count <50x109/L, VTE occurs at a similar rate regardless of platelet count, meaning that cancer patients are at high risk of both clotting and bleeding. Recommendations for inpatient VTE prophylaxis for cancer patients require a targeted approach to identify a subset who would most benefit from VTE prophylaxis. Disclosures Flanders: Institute for Healthcare Improvement and the Society of Hospital Medicine: Consultancy; Wiley Publishing: Patents & Royalties; CDC Foundation: Research Funding; Blue Cross Blue Shield of Michigan: Research Funding; Michigan Hospital Association: Research Funding. Sood:Bayer: Research Funding.

Venous Thromboembolic Risk and Suboptimal Prophylaxis in the US Acute Hospital Care Setting: Findings from the ENDORSE Study.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1858-1858
Author(s):  
Victor F. Tapson ◽  
Alexander T. Cohen ◽  
Jean-Francois Bergmann ◽  
Samuel Goldhaber ◽  
Ajay K. Kakkar ◽  
...  
Keyword(s):  
At Risk ◽  
Acute Care ◽  
Care Setting ◽  
Acute Care Hospitals ◽  
Surgical Patients ◽  
Medical Patients ◽  
Acute Hospital Care ◽  
Vte Prophylaxis ◽  
Patients At Risk ◽  
Risk Patients

Abstract Introduction Estimates for patients at risk of venous thromboembolism (VTE) in US acute care hospitals total approximately 4 million surgical and 8 million medical patients annually. However, limited data are available regarding practices in VTE prevention in the acute care setting. The ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk of Venous Thrombosis in the Acute Hospital Care Setting) study is a worldwide survey of inpatients in acute hospital care. We assessed data from US acute care hospitals to determine the prevalence of VTE risk and proportion of at-risk patients receiving prophylaxis in accordance with current ACCP guidelines. Methods During the period August 2006 to January 2007, 9257 patients were enrolled from 81 randomly-selected US acute care hospitals. All medical patients ≥40 years, surgical patients ≥18 years, or patients ≥18 years admitted for non-surgical trauma were eligible for the study. Patients admitted to an ineligible ward, with missing data, or admitted solely for the treatment of VTE were excluded from the analysis. Patient charts were reviewed during a single day, pre-defined visit, with the evaluation criteria including medical history, admission and post-admission diagnoses, type of surgery, bleeding risks, and initiation and type of prophylaxis. The ACCP consensus guidelines were used to evaluate VTE risk and prophylaxis use in enrolled patients. Results Of the 9257 study patients, 44% and 56% were surgical and medical, respectively. 78% and 52% of surgical and medical patients were judged at risk for VTE, respectively. Of these, 29% of surgical patients and 52% of medical patients failed to receive recommended types of prophylaxis (Table). Among at-risk patients who received recommended types of VTE prophylaxis, a majority received anticoagulants (90% surgical, 97% medical). Table: VTE risk and prescription of recommended types of prophylaxis in US acute care hospitals US patients [X, range*] At-risk for VTE [X, range*] At-risk patients who received ACCP-recommended prophylaxis [X, range*] *Mean and range across all 81 US hospitals All (N=9257) 5885 [64%] 3536 [60%] Surgical (N=4061) [44%,13–94] 3165 [78%, 21–100] 2244 [71%, 0–100] Medical (N=5196) [56%, 6–87] 2720 [52%, 19–100] 1292 [48%, 0–100] Conclusions These data from US acute care hospitals parallel the global ENDORSE study findings of the high prevalence of VTE risk and suboptimal provision of ACCP-recommended prophylaxis. Although a higher proportion of surgical patients were judged to be at risk of VTE, the absolute number of hospitalized medical patients was higher and half of these did not receive adequate VTE prophylaxis. Our data highlight the continued need for strategies to ensure that hospital patients at risk of VTE are identified and provided with adequate VTE prophylaxis.

The Unmet Need for Extended Thromboprophylaxis in Acutely Ill Medical Patients: The Findings of IMPROVE, ENDORSE and EXCLAIM.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1981-1981
Author(s):  
Frederick A Anderson ◽  
Russell D Hull ◽  
Sebastian M Schellong ◽  
Bruno Deslandes ◽  
Victor F Tapson ◽  
...  
Keyword(s):  
At Risk ◽  
Unmet Need ◽  
Bed Rest ◽  
Medical Illness ◽  
Medical Patients ◽  
Eligibility Criteria ◽  
Vte Prophylaxis ◽  
Patients At Risk ◽  
Discharge From Hospital ◽  
Reduced Mobility

Abstract Introduction: Findings from the recent EXCLAIM study demonstrate that selected acutely ill medical patients with reduced mobility benefit from extended-duration enoxaparin venous thromboembolism (VTE) prophylaxis (Blood2007;110:1862). However, it is unknown whether the EXCLAIM population is representative of acutely ill medical patients admitted to hospitals worldwide. In this subanalysis, we assessed whether the EXCLAIM population was representative of the medical patients enrolled in the multinational IMPROVE (Chest2007;132:936–45) and ENDORSE (Lancet2008;371:387–94) registries known to be at risk for VTE. Methods: Using patient data from IMPROVE and ENDORSE, we applied the EXCLAIM eligibility criteria to a representative, multinational population of acutely ill medical patients at risk for VTE. The IMPROVE and ENDORSE studies assessed VTE-risk and prophylaxis use of enrolled patients according to the 2004 American College of Chest Physicians (ACCP) guidelines (Chest2004;126:338S–400S). ACCP criteria for VTE risk were met in 46% (6,907/15,156) of IMPROVE and 43% (15,487/36,351) of ENDORSE study patients (Chest2007;132:936–45; Lancet2008;371:387–94). The EXCLAIM eligibility criteria required patients to be confined to total bed rest (level 1 immobility), or bed rest with bathroom privileges (level 2 immobility) and have at least 1 of 3 predefined risk factors for VTE (i.e., age &gt; 75 years; history of VTE; active or prior cancer). Results: EXCLAIM eligibility criteria were met in 30% (2,072/6,907) IMPROVE and 36% (5,535/15,487) ENDORSE medical patients considered at risk for VTE by ACCP. During hospitalization, ACCP-recommended prophylaxis was provided to 69% (1,426/2,072) and 46% (2,548/5,535) of EXCLAIM-eligible patients enrolled in IMPROVE and ENDORSE, respectively. Following discharge from hospital (median length of stay 5 days for US, 8 days for non-US), only 9% (153/1,719) of EXCLAIM-eligible patients in the IMPROVE study received any type of ACCP-recommended VTE prophylaxis. Conclusions: Evidence from the EXCLAIM study demonstrated that the benefit-to-risk ratio in selected hospitalized medical patients favors the use of prolonged VTE prophylaxis. This population corresponds to one in three of the representative hospitalized patients with acute medical illness enrolled in IMPROVE and ENDORSE. Data on prophylaxis use from the IMPROVE registry suggest that only 9% of such patients are currently receiving optimal VTE prophylaxis following hospital discharge.

Comparison of the two-year outcomes and costs of prophylaxis in medical patients at risk of venous thromboembolism

2008 ◽  
Vol 100 (05) ◽  
pp. 810-820 ◽  
Author(s):  
Russ Becker ◽  
Jay Lin ◽  
Josh Benner ◽  
Steven B. Deitelzweig
Keyword(s):  
At Risk ◽  
Clinical Effectiveness ◽  
Medical Costs ◽  
Decision Analytic Model ◽  
Medical Patients ◽  
Prevention Strategies ◽  
Vte Prophylaxis ◽  
Direct Medical Costs ◽  
Patients At Risk ◽  
Total Average

SummaryA decision-analytic model incorporating a Markov process to assess the incremental cost and effectiveness of venous throm-boembolism (VTE) prevention strategies was used. Modeling was carried out using a hypothetical cohort of medical patients at risk of VTE.The model compared clinical effectiveness (primary and recurrent VTE, death), safety (adverse events), and direct medical costs between patients receiving enoxaparin prophylaxis, unfractionated heparin (UFH) prophylaxis, and no prophylaxis (n=10,000 for each arm). Monte Carlo simulation was performed to identify changes in inputs that would affect the results.The estimated incidence of VTE at two years (including recurrentVTE) was 6.8% with enoxaparin prophylaxis, 7.9% with UFH prophylaxis,and 17.9% with no prophylaxis.Two-year mortality occurred in 15.7% of enoxaparin patients and 16.0% of UFH patients, with the incidences of major bleeding in these groups being 0.7% and 1.2%, respectively. However, both enoxaparin and UFH prophylaxis were associated with higher rates of major bleeds than no prophylaxis (0.6%).Total average costs per patient were (US dollars) $1,264 (for enoxaparin prophylaxis, $1,585 for UFH prophylaxis,and $2,245 for no prophylaxis).No realistic parameter changes resulted in enoxaparin prophylaxis being more costly than UFH prophylaxis. For the healthcare payer, considering all direct medical costs associated with VTE up to two years after an admission for acute illness, prophylaxis with enoxaparin was more effective and less costly than UFH. This identifies enoxaparin as a potentially favorable VTE prophylaxis regimen compared with UFH and no prophylaxis in at-risk medical patients

scholarly journals Use of thromboprophylaxis for venous thromboembolism among patients admitted in medical ward

2019 ◽  
Vol 6 (1) ◽  
pp. 83-88
Author(s):  
Ujjawal Paudel ◽  
Prashant Raj Bhatt ◽  
Choodamani Nepal
Keyword(s):  
At Risk ◽  
Venous Thromboembolism ◽  
Acute Infection ◽  
Tertiary Care ◽  
Medical Ward ◽  
Assessment Model ◽  
Medical Patients ◽  
Cross Sectional ◽  
Vte Prophylaxis ◽  
Risk Of Bleeding

 Introductions: Studies have shown inadequate use of prophylaxis for venous thromboembolism (VTE) in hospital admitted medical patients. This study aims to evaluate the use of VTE prophylaxis in admitted medical patients in a tertiary care teaching hospital. Methods: This was a cross sectional observational study for three weeks from 19 March to 8 April 2017 in patients admitted in the medical ward of Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. Patient charts were reviewed for appropriate VTE prophylaxis as per modified Padua risk Assessment model. Risks of VTE, presence of bleeding risks, demographics (age, BMI), hospital stay were descriptively analysed. Results: Out of 122 patients, 81 (66.4%) were at risk of VTE. Among 81 at risk, 69 were eligible for VTE pharmacoprophylaxis with no risk of bleeding only 29 (42%) received pharmacoprophylaxis and 12 eligible for prophylaxis but with the risk of bleeding did not receive any prophylaxis. Reduced mobility was the most common indication of thromboprophylaxis in 79 (64%), followed by acute infection 50 (41%). Conclusions: There was suboptimal use of thromboprophylaxis in hospital admitted medical patients at risk of venous thromboembolism, VTE.

Trends In Thromboprophylaxis Use In US Hospitals, 2006–2010

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1707-1707 ◽  
Author(s):  
Scott D Grosse ◽  
Rodney J Presley ◽  
Hussain Yusuf ◽  
Lisa C. Richardson ◽  
Alpesh N Amin
Keyword(s):  
Infectious Disease ◽  
At Risk ◽  
Lung Disease ◽  
Acute Care ◽  
Research Funding ◽  
Risk Groups ◽  
Relative Increase ◽  
Patient Groups ◽  
Severe Lung Disease ◽  
Severe Lung

Abstract The use of thromboprophylaxis among at-risk groups of inpatients to prevent hospital-associated venous thromboembolism (HA-VTE) has long been considered suboptimal. Little is known, though, whether utilization of anticoagulants in inpatient settings has increased in recent years. The objective of this study was to assess trends in the administration of anticoagulants to inpatients in a sample of US hospitals from 2006 through 2010 and to further evaluate how trends in utilization vary by type of patient group. A comprehensive national database of all-payer billing records from more than 600 US acute care hospitals, the Truven Health MarketScan® Hospital Drugs Database, was accessed for the years 2006 through 2010. Uniquely, this national hospital database contains records on prescription medications administered in the inpatient setting. Data were analyzed for a subset of hospitals for which an indicator of potential record error was zero. Data for this analysis were contributed by 394 hospitals in 2006 and 333 hospitals in 2010. The analysis was restricted to inpatient admissions of longer than 1 day for adult (age ≥ 18 years) patients who were neither admitted from nor discharged to another acute care hospital (i.e., no hospital transfers). Records were excluded for admissions with a diagnosis that could require anticoagulation for treatment, i.e., deep vein thrombosis, pulmonary embolism, atrial fibrillation, stroke, or myocardial infarct. Total admissions included were 3,188,966 in 2006 and 2,554,806 in 2010. For the purposes of this study, records with one or more prescriptions for the following anticoagulants--enoxaparin, dalteparin, fondaparinux, or warfarin--were classified as presumed thromboprophylaxis since conditions for which anticoagulants are prescribed as treatment had been excluded. In addition, administration of unfractionated heparin of 1,000 U or more was considered prophylactic; low-dose heparin prescriptions (< 1000 U) were assumed to be used as a heparin flush. Anticoagulation prophylaxis rates were assessed for all inpatients and for 5 selected at-risk patient groups based on ICD-9-CM codes used for the same patient groups in Amin A, et al. (2011; 2012): hip/knee surgery, cancer, congestive heart failure (CHF), severe lung disease (including chronic obstructive pulmonary disease), and infectious disease. The associated numbers of admissions in 2010 and the percentages of all admissions for the five at-risk groups are: 52,517 (2.1%) knee/hip, 127,407 (5.0%) cancer, 33,212 (1.3%) severe lung disease, 28,514 (1.1%) CHF, and 27,541 (1.1%) infection. Provisional results indicate that the frequency of administration of thromboprophylaxis in a sample of US inpatient hospitalizations increased over time, from 34.0% in 2006 to 41.40% in 2010, a relative increase of 21.5% in a 4-year period. The use of anticoagulation was highest among major orthopedic surgical patients at each point, 85.97% in 2006 and 87.40% in 2010. The second highest use was observed in hospitalizations for patients with severe lung disease, increasing from 65.33% in 2006 to 69.63% in 2010. Use of anticoagulants for hospitalizations with CHF diagnoses increased from 60.61% in 2006 to 67.99% in 2010. Increases in use of anticoagulation were larger in both absolute and relative terms for two other groups of at-risk hospitalizations. For hospitalizations associated with infectious disease diagnoses, the frequency of use increased from 46.03% in 2006 to 57.71% in 2010, a relative increase of 25.4%. Finally, the largest relative increase in thromboprophylaxis use in at-risk patient groups was observed for hospitalizations associated with cancer diagnoses, among which use increased from 40.52% in 2006 to 52.53% in 2010, a relative increase of 29.6%. These data suggest that substantial increases have occurred in recent years in the frequency with which anticoagulants are prescribed to US inpatients for the prevention of HA-VTE. Additional analyses are being conducted to assess whether increased use of anticoagulants for thromboprophylaxis has been associated with outcomes such as changes in the frequency of in-hospital bleeding events that require treatment. Disclosures: Amin: Johnson & Johnson: Research Funding, Speakers Bureau; BMS/Pfizer: Research Funding, Speakers Bureau.

Sign in / Sign up

Export Citation Format

Share Document