Clinical Predictors of Prophylaxis Use Prior to the Onset of Acute Venous Thromboembolism in Hospitalized Patients: Swiss Venous ThromboEmbolism Registry (SWIVTER)

Kucher, Nils; Spirk, David; Mazzolai, Lucia; Nobel, Daniel; Borggrefe, Martin; Frauchiger, Beat; Bounameaux, Henri

doi:10.1182/blood.v112.11.3019.3019

Cited by 16 publications

(28 citation statements)

References 14 publications

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“…24 Nonadherence to guidelines continues to be a significant issue, and likely contributes, at least in part, to stable or increasing incidence of in-hospital VTE. 22,25 Inadequate or inaccurate risk estimation has been shown to lead to poor outcomes. 26 The causes of this are multifactorial.…”

Section: The Institution Of Risk Assessment In the Hospital Systemmentioning

confidence: 99%

“…21 This is likely due to the proliferation of high-risk surgical patients, and the continuing failure of appropriate application of thromboprophylaxis. 22 Though medical patients fail to receive appropriate prophylaxis at higher rates, up to 30% of surgical patients do not receive prophylaxis when they should. 22 Questions remain about the safety and effectiveness of pharmacoprophylaxis, and exactly which patients ought to receive it.…”

mentioning

confidence: 99%

“…22 Though medical patients fail to receive appropriate prophylaxis at higher rates, up to 30% of surgical patients do not receive prophylaxis when they should. 22 Questions remain about the safety and effectiveness of pharmacoprophylaxis, and exactly which patients ought to receive it. There is, unfortunately, inadequate consensus across guideline statements regarding this issue.…”

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confidence: 99%

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Scoring Systems for Estimating Risk of Venous Thromboembolism in Surgical Patients

Jacobs

Pannucci

2017

Semin Thromb Hemost

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Venous thromboembolism (VTE) is one of the most common and feared complications in surgical patients, and its prevention has been the subject of a Call to Action from the Surgeon General of the United States. Here, we review the literature on the use of risk assessment models for the stratification of surgical patients into risk groups to guide the administration of pharmacoprophylaxis. Despite some disagreement in the literature and among various guidelines, there is good evidence that risk stratification identifies a 7- to 20-fold variation in postoperative VTE risk among the overall surgical population, including patients at both low and high risk. This information is useful to providers who are making decisions about mechanical prophylaxis and pharmacoprophylaxis.

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Section: The Institution Of Risk Assessment In the Hospital Systemmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Scoring Systems for Estimating Risk of Venous Thromboembolism in Surgical Patients

Jacobs

Pannucci

2017

Semin Thromb Hemost

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“…Despite the overwhelming evidence supporting thromboprophylaxis for most hospital patients, the rates of prophylaxis use are far from optimal [5,6,40–47]. In fact, audits demonstrate that the majority of medical, surgical and cancer patients do not receive appropriate thromboprophylaxis [5,6,40–47]. There is a strong link between suboptimal prophylaxis rates and both symptomatic VTE and increased costs of care [47–50].…”

Section: Prophylaxis Use/adherence With the Guidelinesmentioning

confidence: 99%

“…In fact, audits demonstrate that the majority of medical, surgical and cancer patients do not receive appropriate thromboprophylaxis [5,6,40–47]. There is a strong link between suboptimal prophylaxis rates and both symptomatic VTE and increased costs of care [47–50]. For example, cancer patients receiving thromboprophylaxis that was partially compliant with the ACCP guidelines had a higher risk of VTE and higher total hospital costs than patients whose prophylaxis was fully adherent with the guidelines [50].…”

Section: Prophylaxis Use/adherence With the Guidelinesmentioning

confidence: 99%

Prevention of venous thromboembolism: a key patient safety priority

Geerts

2009

Journal of Thrombosis and Haemostasis

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Summary. It is more than 50 years since the first publication of a study showing that symptomatic and fatal venous thromboembolism could be reduced with the use of thromboprophylaxis. Furthermore, it is 23 years since the first evidence-based guidelines recommended routine use of thromboprophylaxis for most hospitalized patients. However, despite the overwhelming evidence that thromboprophylaxis safely and inexpensively reduces thromboembolic complications associated with acute illness and surgery, there continue to be large gaps in the provision of this key patient safety intervention and even larger gaps in the provision of optimal thromboprophylaxis. The implementation of quality improvement strategies, both at the national level and in local hospitals, are able to increase awareness of thromboembolic risks, to increase adherence to thromboprophylaxis guidelines, and to decrease both clinically important thromboembolic events and hospital costs. Therefore, the objective is for every hospitalized patient to receive appropriate thromboprophylaxis based on their thromboembolic and bleeding risks.

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Venous thromboembolism risk factors and usefulness of a risk scoring system in lower limb orthopedic surgery

et al. 2022

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We previously developed a computerized clinical decision support system based on national consensus guidelines and previous studies. This system was used to assess the risk of venous thromboembolism. In this study, we examined the risk factors for venous thromboembolism in patients who underwent lower limb orthopedic surgery using our risk scoring system, to investigate the association between the total risk score and the occurrence of venous thromboembolism. We retrospectively evaluated the records of 649 patients who underwent lower limb orthopedic surgery at a tertiary care center in Japan between January 2015 and August 2018. Venous thromboembolism was confirmed using ultrasonography or computed tomography angiography. The computerized clinical decision support system was used throughout the hospitalization period. Independent risk factors for postoperative venous thromboembolism were identified using logistic regression analysis. Age (≥68 years) was significantly associated with an increased risk of venous thromboembolism (adjusted odds ratio: 1.06, 95% confidence interval: 1.03–1.09; P < 0.001). Furthermore, the Cochran–Armitage trend test revealed a significant positive correlation between the total risk score and the occurrence of venous thromboembolism ( P < 0.001). Our risk scoring system may be used preoperatively to determine the need for venous thromboembolism prophylaxis. This study suggests that age (≥68 years) may be a risk factor for venous thromboembolism after lower limb orthopedic surgery. Additional studies are needed to validate these results.

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Clinical Predictors of Prophylaxis Use Prior to the Onset of Acute Venous Thromboembolism in Hospitalized Patients: Swiss Venous ThromboEmbolism Registry (SWIVTER)

Abstract: Clinical predictors of prophylaxis use prior to the onset of acute venous thromboembolism in hospitalized patients SWIss VenousThromboEmbolism Registry (SWIVTER)

Cited by 16 publications

References 14 publications

Scoring Systems for Estimating Risk of Venous Thromboembolism in Surgical Patients

Scoring Systems for Estimating Risk of Venous Thromboembolism in Surgical Patients

Prevention of venous thromboembolism: a key patient safety priority

Venous thromboembolism risk factors and usefulness of a risk scoring system in lower limb orthopedic surgery

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