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https://www.readbyqxmd.com/read/28721003/patient-compliance-with-venous-thromboembolism-prophylaxis-vte
#1
John Ross Blackwell, Parag Raval, John-Patrick Quigley, Amit Patel, Donald McBride
Venous thromboembolic disease (VTE) comprises pulmonary embolism (PE) and deep vein thrombosis (DVT), and causes morbidity and mortality, particularly in trauma and orthopaedic patients. Prevalence of 0.9% and 1.2% respectively are reported, with mortality rates up to 13.8%. Chemical thromboprophylactic agents including low molecular weight heparin (LMWH) are considered cost effective in reducing VTE risk. Evidence for anti-platelets including Aspirin for VTE prophylaxis is less compelling and is not supported as monotherapy...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28719780/venous-thromboembolic-prophylaxis-in-foot-and-ankle-surgery-a-review-of-current-literature-and-practice
#2
Martin H S Weisman, James R Holmes, Todd A Irwin, Paul G Talusan
Venous thromboembolism (VTE) is a well-known and feared complication following foot and ankle surgery, as it is a source of morbidity and mortality in the perioperative phase. The most recent CHEST guidelines recommended against the use of chemoprophylaxis and the majority of the literature has found a low incidence of VTE following foot and ankle surgery. Some authors prefer screening patients for risk factors and recommend the use of chemoprophylaxis on a case-by-case basis. Interestingly, studies that found high incidence of VTE were unable to determine a statistically significant difference between the prophylaxis and placebo groups...
August 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28708786/venous-thromboembolism-in-patients-receiving-extended-pharmacologic-prophylaxis-after-robotic-surgery-for-endometrial-cancer
#3
Josephine S Kim, Kathryn A Mills, Julia Fehniger, Chuanhong Liao, Jean A Hurteau, Carolyn V Kirschner, Nita K Lee, Gustavo C Rodriguez, S Diane Yamada, Elena S Diaz Moore, Meaghan E Tenney
OBJECTIVE: This study aims to determine the rate of postoperative venous thromboembolism (VTE) in endometrial cancer patients undergoing robotic hysterectomy with or without extended pharmacologic VTE prophylaxis. METHODS/MATERIALS: A retrospective chart review of women undergoing robotic hysterectomy with or without other procedures for endometrial cancer from January 2010 to February 2015 was conducted at 2 institutions. Charts were manually abstracted, and rates of VTE within 30 and 60 days after surgery were determined...
July 13, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28706106/detailed-assessment-of-benefits-and-risks-of-retrievable-inferior-vena-cava-filters-on-patients-with-complicated-injuries-the-da-vinci-multicentre-randomised-controlled-trial-study-protocol
#4
Kwok M Ho, Sudhakar Rao, Stephen Honeybul, Rene Zellweger, Bradley Wibrow, Jeffrey Lipman, Anthony Holley, Alan Kop, Elizabeth Geelhoed, Tomas Corcoran
INTRODUCTION: Retrievable inferior vena cava (IVC) filters have been increasingly used in patients with major trauma who have contraindications to anticoagulant prophylaxis as a primary prophylactic measure against venous thromboembolism (VTE). The benefits, risks and cost-effectiveness of such strategy are uncertain. METHODS AND ANALYSIS: Patients with major trauma, defined by an estimated Injury Severity Score >15, who have contraindications to anticoagulant VTE prophylaxis within 72 hours of hospitalisation to the study centre will be eligible for this randomised multicentre controlled trial...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28700413/venous-thromboembolism-after-major-venous-injuries-competing-priorities
#5
Brian Frank, Zoё Maher, Joshua P Hazelton, Shelby Resnick, Elizabeth Dauer, Anna Goldenberg, Andrea L Lubitz, Brian P Smith, Noelle N Saillant, Patrick M Reilly, Mark J Seamon
BACKGROUND: Venous thromboembolism (VTE) after major vascular injury (MVI) is particularly challenging as the competing risk of thrombosis and embolization after direct vessel injury must be balanced with risk of bleeding after surgical repair. We hypothesized that venous injuries, repair type and intraoperative anticoagulation would influence VTE formation after MVI. METHODS: A multi-institution, retrospective cohort study of consecutive MVI patients was conducted at 3 urban, level-I centers (2005-2013)...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28699939/implementing-acove-quality-indicators-as-an-intervention-checklist-to-improve-care-for-hospitalized-older-adults
#6
Liron Sinvani, Andrzej Kozikowski, Christopher Smilios, Vidhi Patel, Guang Qiu, Meredith Akerman, Martin Lesser, David Rosenberg, Gisele Wolf-Klein, Renee Pekmezaris
BACKGROUND: Medicare patients account for approximately 50% of hospital days. Hospitalization in older adults often results in poor outcomes. OBJECTIVE: To test the feasibility and impact of using Assessing Care of Vulnerable Elders (ACOVE) quality indicators (QIs) as a therapeutic intervention to improve care of hospitalized older adults. DESIGN: >Post-test only prospective intervention with a nonequivalent retrospective control group...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28698538/warfarin-should-not-be-used-for-thromboprohylaxis-in-elective-major-orthopaedic-surgery-a-croatian-perspective
#7
Robert Kolundžić, Marijana Šimić Jovičić, Maja Ðinkić, Tadija Petrović, Tomislav Crnković, Vladimir Trkulja
Aim To identify modes of venous thromboembolism (VTE) prophylaxis in patients undergoing elective major orthopaedic surgery (total hip or knee arthroplasty, THA/TKA) at a single university-associated hospital in Croatia. Methods A retrospective analysis of consecutive patients subjected to THA or TKA over a two-year period (2014-2015) with a focus on anticoagulation during the first 15 post-surgical days (period of highest VTE risk). Results Of 603 identified patients three (0.5%) were not anticoagulated (haemophilia) and others received perioperative doses of low molecular weight heparins (LMWH)...
August 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#8
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28680173/venous-thromboembolism-prophylaxis-on-general-internal-medicine-units-are-patients-well-served-by-current-practice
#9
Allison Mejilla, Micheal Guirguis, Sheri Koshman, Tammy J Bungard
BACKGROUND: Venous thromboembolism (VTE) is the most preventable hospital-associated complication, and implementation of appropriate VTE prophylaxis is a requirement for institutional accreditation. However, ambiguity and controversy exist within current recommendations, and greater clarity about and understanding of current utilization of VTE prophylaxis may be needed. OBJECTIVES: The primary objective was to assess the proportion of patients receiving appropriate VTE prophylaxis (right drug, dose, frequency, and duration) within 24 h after admission to general internal medicine units...
May 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28676304/imaging-trends-in-acute-venous-thromboembolic-disease-2000-to-2015
#10
Isaac Wang, Matthew S Davenport, Ella A Kazerooni
PURPOSE: To measure diffusion of new knowledge and correlate imaging utilization for suspected acute venous thromboembolism (VTE) with d-dimer utilization, landmark publications, and institutional guidelines. MATERIALS: Between 2000 and 2015, the number of CT pulmonary angiograms (CTPAs), CTPA combined with indirect CT venography (CTV), ventilation-perfusion (VQ) scans, and lower extremity venous Doppler ultrasound (US) examinations were obtained for inpatients and emergency department (ED) patients and correlated with d-dimer utilization, landmark publications regarding radiation and VTE imaging, and an institutional inpatient best-practice alert requiring VTE prophylaxis assessment (2008)...
July 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28674685/risk-factors-prophylaxis-and-treatment-of-venous-thromboembolism-in-congenital-heart-disease-patients
#11
REVIEW
Michael Silvey, Leonardo R Brandão
Congenital heart disease (CHD) is a common condition in the pediatric population, affecting up to 1% of all live births (i.e., around 40,000 newborns/year in the United States). Although CHD does have a wide range of severity, by the age of 5 years approximately 80% of patients will require at least one surgical intervention to achieve a complete/palliative cardiac repair. Today, in light of their much-improved surgical survival, the care of these patients focuses on morbidity prevention and/or treatment...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28674378/donor-selection-and-prophylactic-strategy-for-venous-thromboembolic-events-in-living-donors-of-liver-transplantation-based-on-results-of-thrombophilia-screening-tests
#12
Hideya Kamei, Yasuharu Onishi, Nobuhiko Kurata, Masatoshi Ishigami, Yasuhiro Ogura
BACKGROUND We reported a strategy of thrombophilia testing-guided venous thromboembolic events (VTE) prophylaxis for living donors of liver transplantation in 2011. The aim of the present study was to evaluate the safety and efficacy of this protocol for VTE prophylaxis. MATERIAL AND METHODS Thrombophilia testing, including protein S (PS), protein C (PC), antithrombin (AT) III, and anti-phospholipid antibody (APLA), was performed in 306 living donor candidates between July 2005 and June 2016. Donors who met any of the criteria of PS <60%, PC <64%, AT-III <70%, and positive APLA were classified into the borderline group and received continuous venous infusion of heparin immediately after surgery, in addition to use of elastic stockings and intermittent pneumatic compression (IPC) until patients were ambulatory...
July 4, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28667866/a-case-that-illustrates-the-challenges-of-managing-pregnant-patients-with-antithrombin-deficiency-more-questions-than-answers
#13
Leslie Skeith, Andrew Aw, Julia Hews-Girard, Natalia Rydz
Using an illustrative case of a patient with antithrombin (AT) deficiency who developed a recurrent venous thromboembolism (VTE) in pregnancy despite therapeutic low-molecular-weight heparin (LMWH), we highlight what is known in the literature and address areas of controversy through a series of questions around the case. The questions we address include the role of anti-Xa monitoring for patients with past VTE on antepartum LMWH, what treatment regimen is recommended for pregnant patients who develop a recurrent VTE while on therapeutic anticoagulation, the role of antepartum AT concentrate prophylaxis, and the management of labor/delivery, epidural anesthesia and postpartum anticoagulation...
June 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28665081/incidence-of-hospital-acquired-thrombosis-hat-in-a-tertiary-care-hospital
#14
M I Khan, C O'Leary, A O'Brien, V Silvari, C Duggan, S O'Shea
Venous thromboembolism (VTE) is a major cause of preventable morbidity and mortality in hospitalized patients. In spite of guidelines, VTE prophylaxis continues to be underutilised, and hospital acquired thrombosis (HAT) continues to be a problem. This study was conducted to estimate the incidence of HAT in a tertiary referral centre and to examine whether VTE risk assessment and thromboprophylaxis (TP) were implemented. Patients 18 years and above, with a radiologically-confirmed acute VTE during the study period of 15 weeks were included...
April 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28650361/pharmacological-thromboembolic-prophylaxis-in-traumatic-brain-injuries-low-molecular-weight-heparin-is-superior-to-unfractionated-heparin
#15
Elizabeth Benjamin, Gustavo Recinos, Alberto Aiolfi, Kenji Inaba, Demetrios Demetriades
OBJECTIVE: We hypothesized that low molecular weight heparin (LMWH) is superior to unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in patients with severe traumatic brain injuries (TBI). SUMMARY BACKGROUND DATA: Pharmacological VTE prophylaxis with LMWH or UH is the current standard of care in TBI. Clinical work suggests that LMWH may be more effective than UH for VTE prophylaxis in trauma patients. Experimental work shows that heparinoids may have neuroprotective properties...
June 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28640782/perioperative-venous-thromboembolism-a-review
#16
Ronald J Gordon, Frederick W Lombard
Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection...
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28623568/evaluation-of-venous-thromboembolism-prophylaxis-in-a-major-hospital-in-a-developing-country
#17
Lubna Gharaibeh, Hanan Sartawi, Diana Ayyad, Tareq Juma, Kamal Albassoumi, Enas Ismail
Background Venous thromboembolism is the most common preventable cause of hospital death. Despite that, there is still a large gap between what we know about venous thromboembolism prophylaxis and what is happening in current practice. Objective To evaluate VTE prophylaxis in Al-Basheer hospital and assess the extent of agreement of physicians' practice with the guidelines. Setting Al-Basheer governmental hospital in Jordan between January 2016 and June 2016. Method In this cross-sectional observational study, patients were randomly selected from medical and surgical wards...
June 16, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28616434/developing-an-economic-case-of-clinical-pharmacists-interventions-on-venous-thromboembolism-prophylaxis-through-service-evaluation
#18
Eun Hee Lee, Victoria Bray, Robert Horne
OBJECTIVE: Venous thromboembolism (VTE) has become a huge health problem as well as a financial burden for the National Health Service. The objective of this study was to characterize current practice of VTE prophylaxis (VTEP) and evaluate the economic impact of clinical pharmacists' interventions (CPIs) on VTEP. METHODS: A prospective service evaluation was conducted in a medical and surgical ward at a tertiary teaching hospital in London from 23 May to 08 June 2016...
April 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28599392/the-laboratory-control-of-anticoagulant-thromboprophylaxis-during-the-early-postpartum-period-after-cesarean-delivery
#19
Ekaterina M Koltsova, Anna N Balandina, Konstantin I Grischuk, Margarita A Shpilyuk, Elena A Seregina, Natalia M Dashkevich, Alexander V Poletaev, Alexey V Pyregov, Gennady T Sukhih, Ilya I Serebriyskiy, Fazly I Ataullakhanov
INTRODUCTION: The incidence of venous thromboembolism (VTE) after cesarean section is up to 0.6%, and the widespread use of cesarean section draws attention to this group. The dosage and duration of low-molecular-weight heparin (LMWH) prophylaxis after delivery is estimated by anamnestic risk-scales; however, the predictive potency for an individual patient's risk can be low. Laboratory hemostasis assays are expected to solve this problem. The aim of this study was to estimate the potency of tests to reflect the coagulation state of patients receiving LMWH in the early postpartum period...
May 25, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28598908/the-rate-of-deep-vein-thrombosis-doubles-in-trauma-patients-with-hypercoagulable-thromboelastography
#20
Jason B Brill, Jayraan Badiee, Ashley L Zander, James D Wallace, Paul R Lewis, Michael J Sise, Vishal Bansal, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE) in trauma can occur in patients at low risk. Conventional coagulation tests do not predict VTE. Studies investigating thromboelastography (TEG) for VTE risk are conflicting and have not included routine surveillance to detect deep vein thrombosis (DVT). We undertook a prospective study of TEG to evaluate its utility in predicting VTE. METHODS: We conducted a prospective cohort study on all adult trauma patients admitted to our level I trauma center from 2013 to 2015...
June 9, 2017: Journal of Trauma and Acute Care Surgery
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