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2014 ; 133
(1
): 25-9
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Risk factors for inpatient venous thromboembolism despite thromboprophylaxis
#MMPMID24300584
Wang TF
; Wong CA
; Milligan PE
; Thoelke MS
; Woeltje KF
; Gage BF
Thromb Res
2014[Jan]; 133
(1
): 25-9
PMID24300584
show ga
INTRODUCTION: Venous thromboembolism (VTE) is the most common preventable cause
of morbidity and mortality in the hospital. Adequate thromboprophylaxis has
reduced the rate of hospital-acquired VTE substantially; however, some inpatients
still develop VTE even when they are prescribed thromboprophylaxis. Predictors
associated with thromboprophylaxis failure are unclear. In this study, we aimed
to identify risk factors for inpatient VTE despite thromboprophylaxis. MATERIALS
AND METHODS: We conducted a case-control study to identify independent predictors
for inpatient VTE. Among patients discharged from the BJC HealthCare system
between January 2010 and May 2011, we matched 94 cases who developed in-hospital
VTE while taking thromboprophylaxis to 272 controls who did not develop VTE.
Matching was done by hospital, patient age, month and year of discharge. We used
multivariate conditional logistic regression to develop a VTE prediction model.
RESULTS: We identified five independent risk factors for in-hospital VTE despite
thromboprophylaxis: hospitalization for cranial surgery, intensive care unit
admission, admission leukocyte count >13,000/mm(3), presence of an indwelling
central venous catheter, and admission from a long-term care facility.
CONCLUSIONS: We identified five risk factors associated with the development of
VTE despite thromboprophylaxis in the hospital setting. By recognizing these
high-risk patients, clinicians can prescribe aggressive VTE prophylaxis
judiciously and remain vigilant for signs or symptoms of VTE.
|Anticoagulants/*therapeutic use
[MESH]
|Case-Control Studies
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Long-Term Care
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Postoperative Complications/drug therapy/prevention & control
[MESH]