Prevention and Management of Venous Thromboembolism

Abstract

Up to 50% of all VTE events occur during or shortly after hospitalization. 1 The morbidity and mortality of VTE is high: about 10% of hospital deaths are associated with PE and nearly one-third of all VTE patients experience a recurrence within 10 years of the initial event. 1 Characteristics of the Guideline SourceUnder the guidance of the McMaster University GRADE Centre, the ASH convened more than 100 experts (eg, hematologists, clinicians from other specialties, and patient representatives) in 10 panels to synthesize the current evidence base, assess certainty in the evidence, and formulate recommendations. 2-5 Panelists disclosed financial and nonfinancial interests, and conflicts of interest were managed through panel composition, disclosure, and recusal. The GRADE approach was used to assess evidence and make recommendations. 6 More than 200 recommendations, subject to public comment, are included as part of the initial 6 chapters peer reviewed and published in Blood Advances (Table ).

Retrospective Analyses Associate Hemostasis Activation Biomarkers With Poor Outcomes in Patients With COVID-19

“…Elevations of D-dimer can occur in those with intravenous lines or the elderly without the presence of thrombosis such as pulmonary emboli. 10-13 Thus, measurement of other markers could be beneficial. Here we demonstrate that fibrin monomers were significantly associated with unfavorable outcomes and that fibrinogen above 500 mg/dL was significantly associated with ICU admission.…”

“…D-dimer values above the reference range are seen in a variety of situations not necessarily related to activation of the coagulation system, including advanced age 10-12 or insertion of an intravenous catheter. 13 Thus, because D-dimer elevation can be nonspecific, the strength of D-dimer testing lies in its negative predictive value for excluding thrombotic events such as pulmonary embolus.…”

Assessment of Coagulation and Hemostasis Biomarkers in a Subset of Patients With Chronic Cardiovascular Disease

“…Most hospital laboratories offer measurement of D-dimer as a marker of recent or ongoing fibrinolysis and clinicians may use the results to assess risk of thrombosis. 2 Importantly, D-dimer values above the reference range can be seen in a variety of situations not necessarily related to activation of the coagulation system, including advanced age 3 , 4 and in the presence of intravenous catheters. 5 This stresses the importance of the test’s negative predictive value, as D-dimer results within the reference range allow clinicians to rule-out certain conditions such as disseminated intravascular coagulation (DIC), pulmonary embolism, or deep vein thrombosis.…”

Wound complications and bleeding with new oral anticoagulants in patients undergoing total joint arthroplasty: A systematic review and meta‐analysis of randomized controlled trials

“…1 It is estimated that VTE occurs in about 1 in 1000 adults annually, and nearly 10% of hospital deaths are caused by PE. 2,3 Generally, the most common agents used for treatment and prophylaxis against VTE after total joint arthroplasty are subcutaneous low molecular weight heparins (LMWHs), fondaparinux and vitamin K antagonists (VKAs) including warfarin. [4][5][6] However, these drugs have some limitations.…”

“…VTE is associated with an increased risk of mortality, hospitalization and chronic complications worldwide 1 . It is estimated that VTE occurs in about 1 in 1000 adults annually, and nearly 10% of hospital deaths are caused by PE 2,3 …”