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Pharmacological thromboprophylaxis

Boriana Guimicheva, Jignesh P Patel, Lara N Roberts, Devi Subramanian, Roopen Arya
INTRODUCTION: Based on current guidelines, many women qualify for postnatal thromboprophylaxis following childbirth, however, little information exists on how adherent women are and their experiences to both pharmacological and mechanical forms of thromboprophylaxis. MATERIALS AND METHODS: Women requiring postnatal thromboprophylaxis were given questionnaire packs exploring their beliefs about enoxaparin, anti-embolic stockings (AES) and intermittent pneumatic compression devices (IPCD)...
November 22, 2018: Thrombosis Research
Gaisa T Kairov, Maksim A Solovev, Larisa Y Kotlovskaya, Vladimir V Udut
One of the crucial risk factors for development of severe postthrombotic disease (PTD) is the recurrence of deep vein thrombosis (DVT). New opportunities for pharmacological thromboprophylaxis of secondary thrombophilia were associated with the direct thrombin inhibitor-Dabigatran (Pradaxa; Boehringer Ingelheim, Germany). We aimed to investigate the daily pharmacodynamics of dabigatran in healthy volunteers and patients with PTD. Treatment with dabigatran in patients with PTD having chronic chronometric hypercoagulation and structural hypocoagulation before the administration of the drug is fraught with excessive anticoagulation and a high risk of clinically significant bleeding...
November 28, 2018: Clinical and Applied Thrombosis/hemostasis
Amna Ejaz, Munis M Ahmed, Azka Tasleem, Muhammad Rafay Khan Niazi, Muhammad Farhan Ahsraf, Imama Ahmad, Asma Zakir, Awais Raza
Thromboembolism is a major complication in hospitalized patients. Intensive care unit (ICU) patients have a greater risk of thrombotic events due to additional risk factors such as immobilization, mechanical ventilation, and central catheters. The diagnosis and management of deep vein thrombosis (DVT) and pulmonary embolism (PE) in critically ill patients are challenging and these conditions are associated with high mortality. Medical thromboprophylaxis with low molecular weight heparin (LMWH) as well as unfractionated heparin (UFH) has been shown to reduce the incidence of thromboembolic events in such patients...
September 21, 2018: Curēus
Muhammad Khan, Faisal Jehan, Terence O'Keeffe, Mohammad Hamidi, Narong Kulvatunyou, Andrew Tang, Lynn Gries, Bellal Joseph
BACKGROUND: Thromboprophylaxis with oral Xa inhibitors (Xa-Inh) are recommended after major orthopedic operation; however, its role in spine trauma is not well-defined. The aim of our study was to assess the impact of Xa-Inh in spinal trauma patients managed nonoperatively. METHODS: A 4-y (2013-2016) review of the Trauma Quality Improvement Program database. We included all patients with an isolated spine trauma (Spine-abbreviated injury scale ≥3 and other-abbreviated injury scale <3) who were managed nonoperatively and received thromboprophylaxis with either low molecular weight heparin (LMWH) or Xa-Inh...
December 2018: Journal of Surgical Research
Pelle Baggesgaard Petersen, Henrik Kehlet, Christoffer Calov Jørgensen
Most international guidelines recommend pharmacological thromboprophylaxis after total hip and knee arthroplasty (THA/TKA) for 10 to 35 days. However, a recent cohort study on fast-track THA and TKA questioned the need for prolonged thromboprophylaxis when length of stay (LOS) is ≤ 5 days. We aimed at re-investigating the incidence of venous thromboembolism (VTE) in fast-track THA and TKA with in-hospital only thromboprophylaxis when LOS was ≤ 5 days. Prospective cohort study from 1 December 2011 to 30 October 2015 on elective unilateral THA/TKA with in-hospital only thromboprophylaxis if LOS was ≤ 5 days...
November 19, 2018: Thrombosis and Haemostasis
R Figueroa, A Alfonso, J López-Picazo, I Gil-Bazo, A García-Mouriz, J Hermida, J A Páramo, R Lecumberri
PURPOSE: Thromboprophylaxis use among medical inpatients, including cancer patients, is suboptimal. We aimed to evaluate the impact of a novel multiscreen version (v2.0) of an e-alert system for VTE prevention in hospitalised cancer medical patients compared to the original software. METHODS: Prospective study including 989 consecutive adult cancer patients with high-risk of VTE. Patients were followed-up 30 days post-discharge. Two periods were defined, according to the operative software...
November 16, 2018: Clinical & Translational Oncology
Yu-Chih Lin, Shen-Hsun Lee, I-Jung Chen, Chih-Hsiang Chang, Chee-Jen Chang, Yi-Chun Wang, Yuhan Chang, Pang-Hsin Hsieh
INTRODUCTION: This study evaluated the incidence of symptomatic pulmonary embolism (PE), subsequent mortality, risk factors, and the effects of pharmacological thromboprophylactic intervention following hip fracture surgery in Taiwan. MATERIALS AND METHODS: A nationwide study was conducted from February 2004 to September 2013. Hip fracture patients were placed into two groups: without symptomatic PE (control group) and with symptomatic PE (PE group). We analyzed the incidence of and risk factors for symptomatic PE, post-operative mortality rate, and effects of pharmacological thromboprophylactic intervention...
October 18, 2018: Thrombosis Research
Jeong-Ok Lee, Ji Yun Lee, Eun Ju Chun, Sang Il Choi, Jin Won Kim, Se Hyun Kim, Yu Jung Kim, Keun-Wook Lee, Jee Hyun Kim, Jong Seok Lee, Soo-Mee Bang
PURPOSE: The aim of this study was to estimate the incidence and predictors of venous thromboembolism (VTE) in medically ill hospitalized elderly cancer patients in a single Korean tertiary hospital. METHODS: Patients were examined for deep vein thrombosis (DVT) by duplex and color Doppler ultrasonography (DUS) of both legs between days 5 and 14 of their hospital stays. The primary endpoint was the incidence of VTE by day 14, which was determined via a composite of DVT detected by routine DUS and symptomatic VTE...
November 5, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Victor M Lu, Mohammed A Alvi, Richard A Rovin, Ekkehard M Kasper
Venous thromboembolism (VTE) after traumatic brain injury (TBI) with intracranial hemorrhage (ICH) presents a serious yet manageable morbidity and mortality risk. This systematic review and meta-analysis aimed to pool the current literature to evaluate whether or not pharmacologic thromboprophylaxis (PTP) administered early after traumatic ICH significantly changes incidence of VTE or hemorrhagic progression when compared to late administration. Systematic searches of seven electronic databases from their inception to July 2018 were conducted following the appropriate guidelines...
October 29, 2018: Neurosurgical Review
Nanna Freund, Jonas E Sabroe, Peter Bytzer, Søren M Madsen
INTRODUCTION: The risk of venous thromboembolism (VTE) is increased by more than 100-fold among hospitalised medical patients compared to subjects in the community. The Danish Council for the Use of Expensive Hospital Medicines has published national guidelines on thromboprophylaxis (TP) in which the risks of VTE and bleeding are balanced. We wanted to investigate the proportion of acutely admitted medical patients for whom thromboprophylaxis was indicated and to what extent the guidelines were followed...
November 2018: Advances in Therapy
Elisa M Jorgensen, Anjie Li, Anna M Modest, Katherine Leung, Tiffany A Moore Simas, Hye-Chun Hur
OBJECTIVE: To evaluate the incidence of postoperative venous thromboembolism after gynecologic surgery by mode of incision. METHODS: We conducted a retrospective cohort study of all patients who underwent gynecologic surgery from May 2006 to June 2015 at two tertiary care academic hospitals in Massachusetts. Billing and diagnosis codes were used to identify surgeries and cases of venous thromboembolism. RESULTS: A total of 43,751 surgical encounters among 37,485 individual patients were noted during the study...
October 5, 2018: Obstetrics and Gynecology
Reinout R O Heijboer, Bart Lubberts, Daniel Guss, A Holly Johnson, Christopher W DiGiovanni
INTRODUCTION: Among patients undergoing below-knee orthopaedic surgery, no consensus exists regarding the need for or type of postoperative prophylaxis to prevent venous thromboembolic (VTE) events. The purpose of this study was to assess the incidence and risk factors associated with symptomatic VTE among orthopaedic patients undergoing below-knee surgery who were subject to different types of pharmacologic thromboprophylactic strategies. METHODS: A total of 20,043 adult patients who underwent surgery for a below-knee orthopaedic condition between August 2005 and August 2015 were identified...
October 4, 2018: Journal of the American Academy of Orthopaedic Surgeons
Nibal Chamoun, Elsy Ramia, Christelle Lteif, Pascale Salameh, Hala Zantout, Georges Ghanem, Rajaa Chatila
BACKGROUND: In this study, the authors utilized the IMPROVE bleeding definition to explore the safety profile of pharmacologic VTE prophylaxis in patients with CLD and concurrent coagulopathy (INR≥ 1.5). METHODS: A retrospective study was conducted on 193 adult patient admissions with a diagnosis of CLD and INR ≥1.5 not due to therapeutic anticoagulation. Patients were stratified based on their receipt of pharmacological thromboprophylaxis or not during hospitalization...
September 17, 2018: Current Medical Research and Opinion
Alexander M Friedman, Cande V Ananth, Jessica A Lavery, Adiel A Fleischer, Cynthia Chazotte, Mary E D'Alton
OBJECTIVE:  To determine whether a state-level initiative to reduce obstetric venous thromboembolism (VTE) risk affected outcomes and process measures. METHODS:  In 2013, the Safe Motherhood Initiative (SMI) developed a VTE safety bundle to reduce obstetric VTE risk. A total of 117 of 124 hospitals providing obstetrical services in New York participated in SMI. Data evaluating thromboembolism events (deep vein thrombosis and pulmonary embolism) and thromboprophylaxis process measures were collected from March through November 2015...
September 13, 2018: American Journal of Perinatology
Tyler C Lewis, Jennifer Cortes, Diana Altshuler, John Papadopoulos
Venous thromboembolism (VTE) is a major health concern associated with significant morbidity and mortality. Critically ill patients are at an increased risk of VTE compared to general medical patients due to unique risk factors: prolonged immobilization, invasive lines and devices, certain medications, and acquired thrombophilia. Furthermore, VTE in the critically ill is associated with increased duration of mechanical ventilation, increased length of intensive care unit and hospital stay, and a trend toward increased mortality...
August 30, 2018: Journal of Intensive Care Medicine
Bogna Grygiel-Górniak, Nattakarn Limphaibool, Mariusz Puszczewicz
Antiphospholipid syndrome (APS) in patients with systemic lupus erythematosus (SLE) displays a severe disease sub-phenotype with vascular manifestations ranging from peripheral thrombosis to neurologic and ophthalmic symptoms. The prevalence of morbidities including thrombosis, renal lesions, and cognitive impairment contributes to a higher risk of organ damage and a reduced quality of life in patients. In addition to the clinical heterogeneity, the diagnostic challenge is heightened in elderly patients as APS-related SLE is primarily diagnosed in young females...
June 2018: Przeglad Menopauzalny, Menopause Review
Kristijonas Milinis, Joseph Shalhoub, Alexander P Coupland, Justin D Salciccioli, Ankur Thapar, Alun Huw Davies
OBJECTIVE: There is an increasing evidence base to support the use of extended pharmacologic thromboprophylaxis in selected surgical patients to prevent venous thromboembolism (VTE). The benefit of graduated compression stockings (GCS) in addition to extended pharmacologic thromboprophylaxis is unclear. The aim of this study was to systematically review the evidence relating to the effectiveness of using GCS in conjunction with extended pharmacologic thromboprophylaxis to prevent VTE in surgical patients...
August 17, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Mohammad Amre Fallaha, Sarkhell Radha, Sheena Patel
Background: Venous thromboembolism (VTE) remains a significant complication following knee and hip arthroplasty. National and international guidelines recommend pharmacological and mechanical thromboprophylaxis following surgery, unless contraindicated, to reduce the risk of VTE. This study aimed to explore the safety and efficacy profile of an adapted thromboprophylaxis regimen consisting of sequential enoxaparin and rivaroxaban for thromboprophylaxis following knee or hip arthroplasty at a London teaching hospital...
2018: Patient Safety in Surgery
Mohammed Biset Ayalew, Boressa Adugna Horsa, Meseret Tilahun Zeleke
Background: Most of hospitalized patents are at risk of developing deep vein thrombosis (DVT). The use of pharmacological prophylaxis significantly reduces the incidence of thromboembolic events in high risk patients. The aim of this study was to assess appropriateness of DVT prophylaxis in hospitalized medical patients in an Ethiopian referral hospital. Methods: Cross-sectional study design was employed. Patients with a diagnosis of DVT, taking anticoagulant therapy, and those who refused to participate were excluded from the study...
2018: International Journal of Vascular Medicine
Katie Lee, Samantha Cham, Sum Lam
Venous thromboembolism (VTE) is a common and preventable cause of morbidity and mortality in hospitalized patients. Low-molecular-weight heparin, low-dose unfractionated heparin, fondaparinux, and warfarin have been the mainstay options for the prevention and treatment of VTE before the emergence of nonvitamin K antagonist oral anticoagulants (NOACs) such as dabigatran, rivaroxaban, apixaban, and edoxaban. Despite the advantages of NOACs in improving patient adherence, none of them are approved for the prevention of VTE in acutely ill medical patients at high risk of thromboembolism...
November 2018: Cardiology in Review
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