Bleeding Risk Secondary to DVT Prophylaxis in Patients With Lower GI Bleeding

Kandel, Anuj R.; Deutsch, Gary B.; Pokharel, Neeti; Knobel, Denis; Marini, Corrado P.; Ritter, G; Barrera, Rafael

doi:10.1378/chest.9893

Cited by 1 publication

(1 citation statement)

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“…This result is in line with the finding from a retrospective database study with patients treated on an intensive care unit because of lower gastrointestinal bleeding. 20 Despite gastrointestinal bleeding, subcutaneous heparin for VTE prophylaxis was administered to more than 50% of the patients. As a consequence, these patients needed significantly more blood transfusions.…”

Section: Discussionmentioning

confidence: 99%

Do Inpatients Receive Risk-Based Prophylactic Treatment for Thrombotic Events?

Nemani

Mühlen

Steffen

et al. 2021

Clin Appl Thromb Hemost

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Background: Current guidelines recommend risk-based use of prophylaxis for preventing medical inpatients from venous thromboembolism (VTE). Little is known about the current prescription practice, and even less whether differences between subspecialists like cardiologists, usually treating patients with thrombotic or thromboembolic diseases, and gastroenterologists, treating more patients with gastrointestinal bleeding complications, exist. Methods: We performed a retrospective chart review of patients on cardiology and gastroenterology wards of our university hospital. Patients with a clear indication for anticoagulation and contraindication against antithrombotic treatment were excluded. A total of 450 patients per specialty were included. Quantitative risk assessment models were used to determine the risk of a VTE (Padua Prediction Score (PPS), IMPROVE Score) and bleeding (IMPROVE-Bleeding and HAS-BLED Score). Results: The overall rate of VTE prophylaxis was high in both patient populations. Significant more low-risk cardiology compared to gastroenterology patients received drug-based prophylaxis. Furthermore, crucial discrepancies were found in the way individual patients would be classified based on PPS and IMPROVE Score. Finally, not the risk category but the length of hospital stay was best at predicting which patient received prophylaxis.

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Section: Discussionmentioning

confidence: 99%