Tag: thromboembolism

Upvote Story 5
This JAMA Clinical Guidelines Synopsis summarizes the American College of Chest Physicians' 2016 recommendations on antithrombotic therapy for venous thromboembolism (VTE). The estimated annual incidence of VTE, defined as DVT of the leg or PE, ranges from 104 to 183 per 100 000 person-years. Compared with those without VTE, the 30-year mortality risk is increased for survivors of an episode of VTE and for survivors of... Read More | Comment
Upvote Story 5
By incorporating algorithms into the electronic health record (EHR), UPMC was able to realize a “dramatic” 72% reduction in missed doses, from 4,331 missed doses in 2014 to 1,193 in 2015, Dr. Neal told attendees in a session focused on hot topics in surgical patient safety. That decrease in missed doses has translated into a decreased rate of VTE, from an already relatively low rate... Read More | Comment
Upvote Story 5
You are working in a small, rural hospital staffed by one physician and one nurse. There are multiple sick patients, all of whom require your attention, but the sickest is probably the 62 year old female with pneumonia and a blood pressure of 75/40 despite 3 liters of normal saline. This is septic shock, and you need to start a vasopressor, but the hospital protocol... Read More | Comment
Upvote Story 11
The presence of airflow limitation did not increase the risk of VTE recurrence in cancer patients with PE. Prospective studies are needed to validate this finding. Among 401 cancer patients with newly diagnosed PE, spirometry-based airflow limitation was observed in 126 (31.4%) patients. Half of the patients had lung cancer, which was more common in the group with airflow limitation (65.1% vs 42.9%, p <... Read More | Comment
Upvote Story 9
This guideline provides timely, evidence-based reversal strategies to assist practitioners in the care of patients with antithrombotic-associated intracranial hemorrhage. Utilizing the GRADE methodology, the committee developed recommendations for reversal of vitamin K antagonists, direct factor Xa antagonists, direct thrombin inhibitors, unfractionated heparin, low-molecular weight heparin, heparinoids, pentasaccharides, thrombolytics, and antiplatelet agents in the setting of intracranial hemorrhage. Read More | Comment
Upvote Story 12
Does use of the pulmonary embolism rule-out criteria (PERC) in emergency department patients with low clinical probability of pulmonary embolism (PE) safely exclude the diagnosis of PE? Among very low-risk patients with suspected PE, randomization to a PERC strategy vs conventional strategy did not result in an inferior rate of thromboembolic events over 3 months. These findings support the safety of PERC for very low-risk... Read More | Comment
Upvote Story 24
A truly practical guidebook for anyone who needs the key information on the diagnosis, management and prevention of venous thromboembolism. Specific areas of focus include understanding the risk factors for VTE and the role of the right ventricle in PE pathophysiology. Efficient algorithms for diagnosis and exclusion of DVT and PE are emphasized. An state-of-the-art review of current techniques for the management of high risk... Read More | Comment
Upvote Story 7
Albuminuria increases the risk for VTE markedly in patients with normal eGFRs compared with those with lower eGFRs. 15,180 (2.2%) VTE events occurred during the study period. Both albuminuria and eGFR were independently associated with VTE. The association of albuminuria and VTE differed by level of eGFR (P for ACR × eGFR interaction < 0.001). Read More | Comment
Upvote Story 3
Betrixaban, a factor Xa inhibitor, has been approved for the prophylaxis of venous thromboembolism (VTE) in at-risk adult patients hospitalized with an acute illness, according to an announcement from the Food and Drug Administration. Approval was based on results from a randomized, double-blind clinical trial in which over 7,000 hospitalized patients at risk for VTE received either extended-duration betrixaban (35-42 days) or short duration enoxaparin... Read More | Comment
Upvote Story 8
Few head-to-head treatment comparisons have sufficient evidence. Most studies evaluated low molecular weight heparin (LMWH), not low-risk interventions (such as aspirin and mechanical devices); most reported on total deep vein thrombosis (DVT), an outcome that includes asymptomatic DVT and is thus of unclear clinical value. In THR, LMWH has lower VTE and adverse event risks than unfractionated heparin; LMWH and aspirin have similar risks of... Read More | Comment
Upvote Story 3
Principles learned from a successful improvement program can increase compliance and reduce hospital acquired VTEs (HA-VTEs) across multiple institutions. Can a single institution’s VTE prophylaxis program be scaled to increase prophylaxis and reduce HA-VTEs across multiple institutions? Hospital systems can reduce HA-VTE and increase VTE prophylaxis by implementing a bundle of interventions and these efforts are highest yield for Oncologic and Surgical populations. Read More | Comment
Upvote Story 5
Based on study of more than 28,000 TJA patients, presurgical ABO blood group testing looks like an inexpensive way to identify patents at increased risk for symptomatic postoperative VTE. Prophylaxis regimens can dramatically lower the chances of a patient developing venous thromboembolism (VTE), one of the most serious complications of total hip (THA) and knee arthroplasty (TKA). The challenge lies in choosing and balancing the... Read More | Comment