Clinical and economic outcomes with appropriate or partial prophylaxis

Thrombosis Research
A N AminK L Schulman

Abstract

Despite the existence of evidence-based guidelines for venous thromboembolism (VTE) prevention, prophylaxis is often inappropriately prescribed. This study compared the efficacy, safety, and cost of appropriate (ACCP-recommended) prophylaxis with partial prophylaxis (not completely conforming to ACCP guidelines) in patients at-risk of VTE receiving enoxaparin or unfractionated heparin. The MarketScan((R)) Hospital Drug Database from Thomson Reuters (January 2004-March 2007), was queried for medical and surgical patients at high risk of VTE, aged > or =40years, and with a hospital stay > or =6days. Univariate and multivariate analyses compared hospital-acquired VTE events, adverse events, and hospital costs between appropriate or partial prophylaxis discharges. Of the 21,001 discharge records included, appropriate prophylaxis was received by 5136 (24.5%) patients. Compared with partial prophylaxis, appropriate prophylaxis was associated with significantly lower incidences of hospital-acquired pulmonary embolism (0.9% vs 0.5%; adjusted odds ratio [OR] 0.55, 95% confidence intervals [CI] 0.35-0.87, P=0.010), and bleeding events (10.7% vs 5.1%; adjusted OR 0.57, 95% CI 0.50-0.66, P<0.001). Total costs per discharge were lower for a...Continue Reading

References

Mar 7, 2006·Thrombosis Research·Susan R KahnUNKNOWN CURVE study investigators
Oct 13, 2006·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Edward BurleighJeff Smith
Oct 13, 2006·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·David A MacDougallJay Lin
Jul 13, 2007·American Journal of Hematology·Frederick A AndersonAlexander T Cohen
Aug 1, 2007·Journal of Thrombosis and Haemostasis : JTH·A AminG Yang
Dec 26, 2007·Clinical Therapeutics·Abir O KanaanA Samer Al-Homsi
May 1, 2008·Journal of Thrombosis and Haemostasis : JTH·G MerliD Battleman

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Citations

Apr 9, 2014·Annals of Surgical Oncology·Sha'Shonda L RevelsJohn D Birkmeyer
Mar 29, 2014·Journal of the American Medical Informatics Association : JAMIA·P E BeelerJ Blaser
May 10, 2011·Journal of Thrombosis and Thrombolysis·J E Stark, W J Smith
Mar 14, 2013·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·Jed DuffCharlie Stratton
Mar 14, 2013·Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing·Karem H AlzoubiSayer I Al-azzam
Nov 13, 2012·Thrombosis Research·Gualberto GussoniUNKNOWN FADOI Permanent Study Group on Clinical Governance
Jan 16, 2021·Aesthetic Surgery Journal·Marcos SforzaRenato Zaccheddu

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