Tag: VTE

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 11
After adjustment for immortal time bias, Inferior Vena Cava (IVC) filter placement was associated with increased 30-day mortality in patients with venous thromboembolic disease (VTE) and a contraindication to anticoagulation. Randomized clinical trials are needed to determine the efficacy of IVC filter placement in patients with VTE and a contraindication to anticoagulation. Of 126 030 patients with VTE, 61 281 (48.6%) were male and the mean (SD)... 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 7
Discharge instructions for VTE have typically included medication management recommendations related to the use of warfarin. In recent years, however, a growing number of alternatives to warfarin, such as direct oral anticoagulants (DOACs) and other anticoagulants are being more widely used. These medications eliminate many of the complex monitoring challenges associated with warfarin, but are not without safety concerns. Since January 1, 2017, Joint Commission... 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 5
The clinical diagnosis of pulmonary embolism (PE) can be challenging given its variable presentation, requiring dependence on objective testing. Decision instruments such as PERC and the Wells’ score help stratify patients to low or high probability, enabling focused use of CT pulmonary angiography (CTPA) for diagnosis. However, despite these algorithms, there is evidence of increasing use of CTPA along with diminishing diagnostic rate (less than... 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