Risk of and prophylaxis for venous thromboembolism in hospital patients. Thromboembolic Risk Factors (THRIFT) Consensus Group.

Cole, Nelson B.; Lippincott‐Schwartz, Jennifer

doi:10.1136/bmj.305.6853.567

Cited by 416 publications

(14 citation statements)

References 79 publications

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“…However, in a study conducted ten years ago, the incidence of symptomatic VTE based on the Kansas state database for retrospective cohorts of patients nursed at home was 1.30 events per 100 person-years of observation [ 8 ]; the mean followup was 233 days and the patients' mean age was 85 years. Substantially, similar findings, also in a historical cohort of patients of about the same average age nursed at home, come from a study in Israel [ 4 ] and one from the Mayo Clinic [ 9 ]. These figures are far from negligible and suggest that there might have been a much higher rate of asymptomatic VTE in these same patients.…”

Section: Discussionmentioning

confidence: 54%

Risk of Venous Thromboembolism in Patients Nursed at Home or in Long-Term Care Residential Facilities

Arpaia

Ambrogi

Penza

et al. 2011

International Journal of Vascular Medicine

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Background. This study investigated the prevalence of and impact of risk factors for deep venous thrombosis (DVT) in patients with chronic diseases, bedridden or with greatly limited mobility, cared for at home or in long-term residential facilities. Methods. We enrolled 221 chronically ill patients, all over 18 years old, markedly or totally immobile, at home or in long-term care facilities. They were screened at the bedside by simplified compression ultrasound. Results. The prevalence of asymptomatic proximal DVT was 18% (95% CI 13–24%); there were no cases of symptomatic DVT or pulmonary embolism. The best model with at most four risk factors included: previous VTE, time of onset of reduced mobility, long-term residential care as opposed to home care and causes of reduced mobility. The risk of DVT for patients with reduced mobility due to cognitive impairment was about half that of patients with cognitive impairment/dementia. Conclusions. This is a first estimate of the prevalence of DVT among bedridden or low-mobility patients. Some of the risk factors that came to light, such as home care as opposed to long-term residential care and cognitive deficit as causes of reduced mobility, are not among those usually observed in acutely ill patients.

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Section: Discussionmentioning

confidence: 54%

Risk of Venous Thromboembolism in Patients Nursed at Home or in Long-Term Care Residential Facilities

Arpaia

Ambrogi

Penza

et al. 2011

International Journal of Vascular Medicine

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“…Patients undergoing surgery are at increased risk of venous thromboembolism (VTE) 3 and, with varicose veins potentially also being a risk factor, post-operative VTE in this cohort represents a significant clinical problem. There have been a number of small single centre studies performed to attempt to quantify this risk 4–6 but no large multicentre study or review has been undertaken.…”

mentioning

confidence: 99%

The incidence of post operative venous thromboembolism in patients undergoing varicose vein surgery recorded in Hospital Episode Statistics

El-Duhwaib

Dyer

et al. 2012

annals

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INTRODUCTIONThe aim of this study was to establish the incidence of post-operative venous thromboembolism (VTE) following varicose vein treatment.METHODSHospital Episode Statistics (HES) data were obtained for all patients undergoing varicose vein treatment between April 2006 and April 2007 to identify those reattending with either deep vein thrombosis or pulmonary embolism within 12 months.RESULTSThe incidence of VTE was 0.51%, which was comparable with the incidence for those undergoing open surgery (0.54%), sclerotherapy (0.19%) and endovenous laser therapy (EVLT) (0.47%). The incidence of VTE in those undergoing combined EVLT and phlebectomy was 1.26% (p=0.01). In contrast to unilateral treatment (all modalities), where bilateral treatment was performed an increase in the incidence of VTE was seen in those undergoing redo (1.62%) and short saphenous system (1.16%) treatments.Overall, 1.02% of cases were performed under local anaesthesia with zero incidence of VTE in this cohort.CONCLUSIONSThe overall incidence of VTE recorded in HES was 0.51% and appears to be highest in those undergoing bilateral redo or short saphenous system surgery as well as those undergoing a combination of EVLT and phlebectomy. The use of VTE prophylaxis, particularly in these groups, is recommended.

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“…Mechanical and pharmacological anticoagulation prophylactic methods can minimize the risk and incidence of VTE events (and subsequent death). Common non-pharmacological VTE prophylaxis measures include early mobilization of the patient [ 10 ], intermittent pneumatic compression [ 11 ] and graduated compression stockings [ 12 ]. In addition, there are a range of pharmacological anticoagulation therapies available [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Venous thromboembolism prophylaxis practice and its association with outcomes in Australia and New Zealand burns patients

et al. 2021

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Background Patients with burn injuries are considered to have an increased risk of venous thromboembolism (VTE). While untreated VTEs can be fatal, no studies have examined chemoprophylaxis effectiveness. This study aimed to quantify the variation in prevalence of VTE prophylaxis use in patients in Australian and New Zealand burns units and whether prophylaxis use is associated with in-hospital outcomes following burn injury. Methods Admission data for adult burns patients (aged ≥16 years) admitted between 1 July 2016 and 31 December 2018 were extracted from the Burns Registry of Australia and New Zealand. Mixed effects logistic regression modelling investigated whether VTE prophylaxis use was associated with the primary outcome of in-hospital mortality. Results There were 5066 admissions over the study period. Of these patients, 81% (n = 3799) with a valid response to the VTE prophylaxis data field received some form of VTE prophylaxis. Use of VTE prophylaxis ranged from 48.6% to 94.8% of patients between units. In-hospital death was recorded in <1% of patients (n = 33). After adjusting for confounders, receiving VTE prophylaxis was associated with a decrease in the adjusted odds of in-hospital mortality (adjusted odds ratio = 0.21; 95% CI, 0.07–0.63; p = 0.006). Conclusions Variation in the use of VTE prophylaxis was observed between the units, and prophylaxis use was associated with a decrease in the odds of mortality. These findings provide an opportunity to engage with units to further explore differences in prophylaxis use and develop future best practice guidelines.

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Risk of and prophylaxis for venous thromboembolism in hospital patients. Thromboembolic Risk Factors (THRIFT) Consensus Group.

Cited by 416 publications

References 79 publications

Risk of Venous Thromboembolism in Patients Nursed at Home or in Long-Term Care Residential Facilities

Risk of Venous Thromboembolism in Patients Nursed at Home or in Long-Term Care Residential Facilities

The incidence of post operative venous thromboembolism in patients undergoing varicose vein surgery recorded in Hospital Episode Statistics

Venous thromboembolism prophylaxis practice and its association with outcomes in Australia and New Zealand burns patients

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