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extended thromboprophylaxis

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https://www.readbyqxmd.com/read/28203409/practice-patterns-in-venous-thromboembolism-vte-prophylaxis-in-thoracic-surgery-a-comprehensive-canadian-delphi-survey
#1
John Agzarian, Lori-Ann Linkins, Laura Schneider, Waël C Hanna, Christian J Finley, Colin Schieman, Marc De Perrot, Mark Crowther, James Douketis, Yaron Shargall
BACKGROUND: The incidence of venous thromboembolic events (VTE) after resection of thoracic malignancies can reach 15%, but prophylaxis guidelines are yet to be established. We aimed to survey Canadian practitioners regarding perioperative risk factors for VTE, impact of those factors on extended prophylaxis selection, type of preferred prophylaxis, and timing of initiation and duration of thromboprophylaxis. METHODS: A modified Delphi survey was undertaken over three rounds with thoracic surgeons, thoracic anesthesiologists and thrombosis experts across Canada...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28197755/direct-oral-anticoagulants-for-extended-duration-thromboprophylaxis-in-hospitalized-medically-ill-patients-are-we-there-yet
#2
Majed S Al Yami, Osamah M Alfayez, Sawsan M Kurdi, Razan Alsheikh
Despite a recommended 7-10 days of thromboprophylaxis, medically ill patients remain at increased risk of developing venous thromboembolism (VTE) after hospital discharge. Here, we present a contemporary review on the efficacy and safety of extended-duration thromboprophylaxis with direct oral anticoagulants (DOACs) in hospitalized medically ill patients. A search of publication and trial databases of controlled trials conducted from 2010 to 2016 using the key terms apixaban, rivaroxaban, and betrixaban showed three phase III trials that met our search criteria...
February 14, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28152776/utilization-and-effectiveness-of-extended-duration-thromboprophylaxis-after-high-risk-abdominopelvic-cancer-surgery
#3
Ling Chen, Soledad Jorge, William M Burke, Ana Tergas, June Hou, Jim Hu, Alfred I Neugut, Cande Ananth, Dawn L Hershman
: 62 Background: Extended-duration thromboprophylaxis for 4 weeks after discharge has been demonstrated to reduce venous thromboembolic events (VTE) in cancer patients undergoing abdominopelvic surgery and is recommended in national guidelines. We examined the utilization and effectiveness of extended-duration low molecular weight heparin prophylaxis in high-risk cancer patients after surgery. METHODS: We analyzed patients with colon, ovarian, and uterine cancer who underwent surgery from 2009-2013 and who were recorded in the MarketScan database...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28078350/efficacy-and-safety-of-extended-thromboprophylaxis-for-medically-ill-patients-a-meta-analysis-of-randomised-controlled-trials
#4
Francesco Dentali, Nicola Mumoli, Domenico Prisco, Andrea Fontanella, Matteo Nicola Dario Di Minno
Compelling evidence suggests that the risk of pulmonary embolism (PE) and deep-vein thrombosis (DVT) persists after hospital discharge in acutely-ill medical patients. However, no studies consistently supported the routine use of extended-duration thromboprophylaxis (ET) in this setting. We performed a meta-analysis to assess efficacy and safety of ET in acutely-ill medical patients. Efficacy outcome was defined by the prevention of symptomatic DVT, PE, venous thromboembolism (VTE) and VTE-related mortality...
January 12, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28009739/who-should-get-extended-thromboprophylaxis-after-bariatric-surgery-a-risk-assessment-tool-to-guide-indications-for-post-discharge-pharmacoprophylaxis
#5
Ali Aminian, Amin Andalib, Zhamak Khorgami, Derrick Cetin, Bartolome Burguera, John Bartholomew, Stacy A Brethauer, Philip R Schauer
OBJECTIVE: To determine the risk factors for 30-day postdischarge venous thromboembolism (VTE) after bariatric surgery and to identify potential indications for extended pharmacoprophylaxis. BACKGROUND: VTE is among most common causes of death after bariatric surgery. Most VTEs occur after hospital stay; still a few patients receive extended pharmacoprophylaxis postdischarge. METHODS: From American College of Surgeons-National Surgical Quality Improvement Program, we identified 91,963 patients, who underwent elective primary and revisional bariatric surgery between 2007 and 2012...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27998890/extended-thromboprophylaxis-with-direct-oral-anticoagulants-for-medical-patients-a-systematic-review-meta-analysis
#6
Derrick L Tao, Jeffrey Y Bien, Thomas G DeLoughery, Joseph J Shatzel
No abstract text is available yet for this article.
December 20, 2016: Blood
https://www.readbyqxmd.com/read/27913478/thrombosis-in-the-setting-of-obesity-or-inflammatory-bowel-disease
#7
Steven R Lentz
Obesity and inflammatory bowel disease (IBD) are systemic inflammatory disorders that predispose to arterial and venous thrombosis through similar prothrombotic mechanisms. Obesity and IBD are chronic risk factors that lead to a persistently elevated risk of thrombosis, although the thrombotic risk with IBD appears to wax and wane with disease severity. Because of the lack of high-quality evidence to guide management decisions, approaches to the prevention and treatment of thrombosis in patients with obesity or IBD are based on extrapolation from general guidelines for antithrombotic therapy...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27900627/extended-duration-versus-short-duration-pharmacological-thromboprophylaxis-in-acutely-ill-hospitalized-medical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
Aaron Y L Liew, Siavash Piran, John W Eikelboom, James D Douketis
Extended-duration pharmacological thromboprophylaxis, for at least 28 days, is effective for the prevention of symptomatic venous thromboembolism (VTE) in high-risk surgical patients but is of uncertain benefit in hospitalized medical patients. We aimed to evaluate the efficacy and safety of extended-duration thromboprophylaxis in hospitalized medical patients. We conducted a systematic PubMed, Medline and EMBASE literature search until June 2016 and a meta-analysis of randomized controlled trials which compared extended-duration with short-duration thromboprophylaxis in hospitalized medical patients...
November 30, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27881569/extended-duration-betrixaban-reduces-the-risk-of-stroke-versus-standard-dose-enoxaparin-among-hospitalized-medically-ill-patients-an-apex-trial-substudy-acute-medically-ill-venous-thromboembolism-prevention-with-extended-duration-betrixaban
#9
C Michael Gibson, Gerald Chi, Rim Halaby, Serge Korjian, Yazan Daaboul, Purva Jain, Douglas Arbetter, Samuel Z Goldhaber, Russel Hull, Adrian F Hernandez, Alex Gold, Olga Bandman, Robert A Harrington, Alexander T Cohen
BACKGROUND: Stroke is a morbid and potentially mortal complication among patients hospitalized with acute medical illness. The potential of extended-duration thromboprophylaxis with the factor Xa inhibitor betrixaban to reduce the risk of stroke compared with standard-dose enoxaparin in this population was assessed in this retrospective APEX trial substudy (Acute Medically Ill Venous Thromboembolism Prevention With Extended Duration Betrixaban). METHODS: Hospitalized acutely medically ill subjects (n=7513) were randomized in a double-dummy double-blind fashion to either extended-duration oral betrixaban (80 mg once daily for 35-42 days) or standard-dose subcutaneous enoxaparin (40 mg once daily for 10±4 days) for venous thromboprophylaxis...
February 14, 2017: Circulation
https://www.readbyqxmd.com/read/27856470/thrombosis-in-the-setting-of-obesity-or-inflammatory-bowel-disease
#10
REVIEW
Steven R Lentz
Obesity and inflammatory bowel disease (IBD) are systemic inflammatory disorders that predispose to arterial and venous thrombosis through similar prothrombotic mechanisms. Obesity and IBD are chronic risk factors that lead to a persistently elevated risk of thrombosis, although the thrombotic risk with IBD appears to wax and wane with disease severity. Because of the lack of high-quality evidence to guide management decisions, approaches to the prevention and treatment of thrombosis in patients with obesity or IBD are based on extrapolation from general guidelines for antithrombotic therapy...
November 17, 2016: Blood
https://www.readbyqxmd.com/read/27849664/perioperative-pharmacological-thromboprophylaxis-in-patients-with-cancer-a-systematic-review-and-meta-analysis
#11
Qiang Guo, Bin Huang, Jichun Zhao, Yukui Ma, Ding Yuan, Yi Yang, Xiaojiong Du
OBJECTIVE: To compare the relative effects between pharmacological thromboprophylaxis and no anticoagulation. BACKGROUND: The efficacy and safety of pharmacological thromboprophylaxis in cancer patients undergoing surgery need to be quantified to guide management. METHODS: We searched multiple electronic databases (up to March 31, 2016) for trials of cancer patients undergoing surgery that assessed the relative benefits and harms of perioperative pharmacological thromboprophylaxis...
November 15, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27723238/incidence-of-pulmonary-embolism-in-patients-with-newly-diagnosed-colorectal-cancer
#12
Eric S Daniel, Anastasia E Dean, Mingjoe Lim, Mobin Master, Peter Gibbs, Ian Faragher
BACKGROUND: Studies have suggested a benefit from extended venous thromboprophylaxis post-operatively in colorectal cancer with an assumed base rate of zero venous thromboembolic events prior to treatment. We aim to establish the incidence of pulmonary embolism in patients with newly diagnosed stage III or IV colorectal cancer prior to any treatment. METHOD: Consecutive patients presenting to a single health service with a new diagnosis of stage III or IV colorectal cancer were identified from a prospective database, for the period between January 2011 and September 2014...
October 9, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27574464/managing-anesthesia-for-cesarean-section-in-obese-patients-current-perspectives
#13
REVIEW
Agnes M Lamon, Ashraf S Habib
Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to antenatal anesthetic consultation. Anesthesia-related complications and maternal mortality are increased in this patient population. The risk of difficult intubation is increased in obese patients...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27569434/extended-duration-enoxaparin-decreases-the-rate-of-venous-thromboembolic-events-after-radical-cystectomy-compared-to-inpatient-only-subcutaneous-heparin
#14
Joseph J Pariser, Shane M Pearce, Blake B Anderson, Vignesh T Packiam, Vivek N Prachand, Norm D Smith, Gary D Steinberg
PURPOSE: Venous thromboembolic events are a significant source of morbidity after radical cystectomy. At our institution subcutaneous heparin was historically given to patients undergoing radical cystectomy immediately before incision and throughout the inpatient stay. In an effort to decrease the overall rate of venous thromboembolism and post-discharge venous thromboembolism, a regimen including extended duration enoxaparin was initiated for patients undergoing radical cystectomy...
February 2017: Journal of Urology
https://www.readbyqxmd.com/read/27444858/abdominal-thrombotic-complications-following-bariatric-surgery
#15
Amihai Rottenstreich, Ram Elazary, Yosef Kalish
BACKGROUND: Thrombotic events involving the portal-splenic-mesenteric venous system (PSMVT) are rare but potentially lethal after bariatric surgery. OBJECTIVES: To investigate the incidence, clinical presentation, management, and outcome of thrombotic events after bariatric surgery. SETTING: Two university hospitals. METHODS: A retrospective review of individuals who underwent bariatric surgery between January 2006 and December 2015...
January 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27387181/portomesenteric-vein-thrombosis-after-laparoscopic-sleeve-gastrectomy-and-laparoscopic-roux-en-y-gastric-bypass-a-36-case-series
#16
Mustapha A El Lakis, Agostino Pozzi, Jad Chamieh, Bassem Safadi
BACKGROUND: Portomesenteric vein thrombosis following laparoscopic bariatric surgical procedures is a serious and potentially lethal complication. It is quite rare, and its clinical presentation, management, and sequelae remain poorly understood. METHODS: We searched PubMed, Medline, Google Scholar, Ovid, and Cochrane databases for articles reporting case series and systematic reviews in the English language on patients who underwent laparoscopic bariatric surgery and had a subsequent portal or mesenteric vein thrombosis...
July 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27353413/risk-of-venous-thromboembolism-following-laparoscopic-surgery-for-gynecologic-malignancy
#17
Haider Mahdi, Qataralnada Aljebori, David Lockart, Laura Moulton
STUDY OBJECTIVE: To determine the incidence of venous thromboembolism (VTE) after laparoscopic surgery for gynecologic cancer DESIGN: Retrospective analysis of the ACS-NSQIP database DESIGN CLASSIFICATION: Retrospective analysis of a national surgical database SETTING: Academic and community health care institutions across the United States PATIENTS: Women who underwent at least one major laparoscopic surgery for uterine, ovarian and cervical cancers INTERVENTION: Data was collected on surgical procedure, patient demographic variables type of malignancy and VTE and mortality outcomes within 30 days of surgery MEASUREMENTS: VTE was defined as deep venous thrombosis requiring therapy (DVT) and pulmonary embolism (PE) confirmed by imaging or autopsy within 30 days of surgery...
June 21, 2016: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27232649/extended-thromboprophylaxis-with-betrixaban-in-acutely-ill-medical-patients
#18
RANDOMIZED CONTROLLED TRIAL
Alexander T Cohen, Robert A Harrington, Samuel Z Goldhaber, Russell D Hull, Brian L Wiens, Alex Gold, Adrian F Hernandez, C Michael Gibson
BACKGROUND: Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. METHODS: Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days...
August 11, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27167767/prevention-of-venous-thromboembolism-amongst-patients-in-an-acute-tertiary-referral-teaching-public-hospital-a-best-practice-implementation-project
#19
Pamela Kathleen Sykes, Kenneth Walsh, Chenqu Mimi Darcey, Heather Lee Hawkins, Duncan Scott McKenzie, Ritam Prasad, Anita Thomas
BACKGROUND: Deep vein thrombosis and pulmonary embolism are known collectively as venous thromboembolism (VTE). These conditions are possible complications in hospitalized patients that can extend hospital stay, result in unplanned readmission, and are associated with long-term disability and death. Despite strong evidence, many patients do not receive optimal thromboprophylaxis. VTE prevention is a top priority in healthcare systems worldwide. AIM: The aim of the project was to establish a standardized hospital-wide VTE prevention program and to improve awareness of, and compliance with, best practice standards in the prevention of VTE...
June 2016: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/27161719/po-32-patient-tumour-and-operative-factors-influencing-perioperative-hypercoagulability-in-colorectal-cancer
#20
H W Clouston, P A Rees, H Shaker, S Duff, C C Kirwan
INTRODUCTION: Up to 6% of patients develop venous thromboembolism (VTE) following elective colorectal cancer surgery despite thromboprophylaxis. Clinical practices for perioperative thromboprophylaxis remains variable, particularly the use and duration of extended thromboprophylaxis. Identification of factors associated with a prolonged postoperative hypercoagulable state may allow the development of algorithms that allow more targeted thromboprophylaxis. AIM: To identify patient, tumour and surgical risk factors for prolonged (two and six weeks) hypercoagulability in colorectal cancer patients undergoing surgical resection...
April 2016: Thrombosis Research
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