Suboptimal use of pharmacological venous thromboembolism prophylaxis in cirrhotic patients

Internal Medicine Journal
Linda S YangDamian Dowling

Abstract

Cirrhosis was previously perceived as a haemorrhagic disease state due to frequent associations with coagulopathy and bleeding. However, the coagulopathy of cirrhosis is complex with defects in both procoagulant and anticoagulant factors. Derangements in common laboratory indices of coagulation do not accurately reflect bleeding risk or protection from thrombotic events. To assess the rate of pharmacological prophylaxis for venous thromboembolism (VTE) among hospital inpatients with cirrhosis and analyse factors associated with prophylaxis being inappropriately withheld. A retrospective cohort study was performed in a tertiary teaching hospital. Patients included were admitted for greater than 48 h with discharge diagnosis codes corresponding to chronic liver disease and/or cirrhosis. The use of VTE chemoprophylaxis with enoxaparin was assessed in cirrhotic patients and non-cirrhotic controls. Patient data collected included contraindications to prophylaxis, known high-risk varices, international normalised ratio (INR), creatinine, bilirubin, haemoglobin and platelet count. Of 108 patients with cirrhosis eligible for VTE prophylaxis, 61 (56.5%) received prophylaxis compared to 104 (96.3%) non-cirrhotic patients. Platelets and I...Continue Reading

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Citations

Mar 29, 2019·Critical Care Medicine·Yusrah HarahshehKwok M Ho
Dec 5, 2019·European Journal of Haematology·Jessica P E DavisNicolas M Intagliata
Nov 21, 2018·Cancers·Alberto ZanettoFrancesco Paolo Russo
Oct 20, 2020·Internal and Emergency Medicine·Francesco VioliDaniele Pastori
Feb 11, 2020·JHEP Reports : Innovation in Hepatology·Laura TurcoErica Villa

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