Real-life use of thromboprophylaxis in patients hospitalized for pulmonary disorders: A single-center retrospective study

Łukaszuk, Robert F.; Plens, Krzysztof; Undas, Anetta

doi:10.17219/acem/68474

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…Our study reported that prophylactic LMWH is more commonly used among lung cancer inpatients compared with those suffering from a wide range of pulmonary diseases in the same Polish tertiary hospital [ 20 ]. Awareness of the VTE risk, as the most common preventable cause of death in hospitals, has increased in Poland, where several local guidelines have been issued over the last 10 years [ 10 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

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The comparison between Caprini and Padua VTE risk assessment models for hospitalised cancer patients undergoing chemotherapy at the tertiary oncology department in Poland: is pharmacological thromboprophylaxis overused?

Łukaszuk

Dolna-Michno

Plens

et al. 2018

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Aim of the studyThromboprophylaxis in cancer patients during hospitalization reduces the risk of venous thromboembolism (VTE).Material and methodsTo assess the underuse and the overuse of thromboprophylaxis in cancer patients at a tertiary oncology department, we retrospectively analyzed 1983 consecutive hospitalizations of 498 cancer patients who received chemotherapy from October 2016 to May 2017. The Padua prediction score (≥ 4 points) and Caprini risk assessment (≥ 5 points) were used to identify patients at high risk of VTE.ResultsThe majority of individuals (n = 363, 72.9%) suffered from advanced lung cancer. We found that 419 (84.14%) patients received thromboprophylaxis with enoxaparin 40 mg qd,including 181 (43.2%) individuals using concomitant mechanical thromboprophylaxis. As few as 44 (8.8%) and 11 (2.2%) patients did not receive thromboprophylaxis despite high VTE risk based on the Caprini risk assessment and Padua prediction score, respectively (p < 0.001). The number of patients without high risk of VTE, who received pharmacological thromboprophylaxis, was higher when the Padua prediction score was used compared with the Caprini risk assessment (n = 391 [78.5%] vs. n = 210 [42.2%], respectively; p < 0.001). Three patients (0.6%) experienced vascular events during hospital stay, including one symptomatic deep vein thrombosis. No major bleeding was observed. Predictors of thromboprophylaxis overuse were as follows: previous VTE and abnormal pulmonary function for both scales.ConclusionsThis study shows that thromboprophylaxis in cancer in patients undergoing chemotherapy is suboptimal in Poland in part due to the use of various VTE risk scores yielding discrepant results in everyday practice.

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Section: Discussionmentioning

confidence: 99%

“…We used two validated scoring systems to identify patients at high risk for VTE when hospitalized, i.e. the Padua prediction score and Caprini VTE risk assessment [ 3 , 19 , 20 ]. The Padua prediction score, indicating a high risk, was defined as a score of 4 or higher.…”

Section: Methodsmentioning

confidence: 99%

The comparison between Caprini and Padua VTE risk assessment models for hospitalised cancer patients undergoing chemotherapy at the tertiary oncology department in Poland: is pharmacological thromboprophylaxis overused?

Łukaszuk

Dolna-Michno

Plens

et al. 2018

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“…A retrospective study based on prediction scores found that 65.2% of patients did not receive suitable coagulation prophylaxis (p < 0.001). Hence, it was concluded that coagulation prophylaxis is underused in hospital patients with pulmonary diseases by taking into consideration the scoring system used [46,47]. Severe patients, mechanical ventilation, and medications such as sedatives were the main risk factors that contributed to the high risk of VTE.…”

Section: Discussionmentioning

confidence: 99%

Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review

Gaspar

Rinaldi²,

Mello³

et al. 2023

J Infect Dev Ctries

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Introduction: This review aimed at investigating the impact of bundle components on the prevention of ventilator-associated pneumonia (VAP) in adults and the elderly. Methodology: The databases consulted were PubMed, EBSCO, and Scielo. The terms Bundle and Pneumonia were searched in combination. The original articles were selected in Spanish and English; published between January 2008 and December 2017. After eliminating the duplicate papers, an analysis of the titles and the abstracts was performed in order to select the assessed articles. A total of 18 articles were included in this review that were evaluated according to the following criteria: research reference, country of data collection, type of study, characteristics of the studied patients, analysis and intervention performed, bundle items investigated and their results, and research outcome. Results: Four bundle items were presented in all the investigated papers. 61% of those works were considered from seven to eight bundle items. Daily evaluation of sedation interruption and daily assessment for verifying extubation condition, head-of-bed elevation at 30 degrees, cuff pressure monitoring, coagulation prophylaxis, and oral hygiene were the most reported bundle items. One study described the increased mortality of patients under mechanical ventilation when omitted the bundle items of oral hygiene and stress ulcer prophylaxis. Head-of-bed elevation at 30 degrees was the item reported in 100% of the studied papers. Conclusions: Existing research demonstrated that VAP reduction occurred when bundle items were performed for adults and the elderly. Four works showed the relevance of team education as a central approach to the event reduction related to the ventilator.

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“…The 2014 cohort comprises all adult patients hospitalized from April 1, 2014, to December 31, 2014, who were admitted prior to the implementation of the use of the Caprini tool. 17 All archived records of patients were analyzed and scored using the Caprini VTE risk assessment tool, and the final score was compared with archived records of admitted patients who received thromboprophylaxis.…”

Section: Methodsmentioning

confidence: 99%

“…16 A frequent overuse and underuse of thromboprophylaxis was observed in our previous study when the decision to administer prophylaxis was at the discretion of the treating physician. 17 To improve thromboprophylaxis, a computerized system based on the Caprini risk assessment was implemented.…”

Section: Introductionmentioning

confidence: 99%

Caprini VTE computerized risk assessment improves the use of thromboprophylaxis in hospitalized patients with pulmonary disorders

Łukaszuk¹,

Nycz²,

Plens³

et al. 2021

Adv Clin Exp Med

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Real-life use of thromboprophylaxis in patients hospitalized for pulmonary disorders: A single-center retrospective study

Abstract: Background. Underuse of thromboprophylaxis in hospitalized medical patients is still common worldwide. Little is known about the use of thromboprophylaxis in patients with pulmonary diseases in everyday hospital practice.

Cited by 5 publications

References 19 publications

The comparison between Caprini and Padua VTE risk assessment models for hospitalised cancer patients undergoing chemotherapy at the tertiary oncology department in Poland: is pharmacological thromboprophylaxis overused?

The comparison between Caprini and Padua VTE risk assessment models for hospitalised cancer patients undergoing chemotherapy at the tertiary oncology department in Poland: is pharmacological thromboprophylaxis overused?

Impact of evidence-based bundles on ventilator-associated pneumonia prevention: A systematic review

Caprini VTE computerized risk assessment improves the use of thromboprophylaxis in hospitalized patients with pulmonary disorders

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