| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
* From the Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA.
Correspondence to: Samuel Z. Goldhaber, MD, FCCP, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115; e-mail: sgoldhaber{at}partners.org
Context: Guidelines to prevent venous thromboembolism (VTE) have been widely distributed and generally have been assumed to be effective. Therefore, among hospitalized patients, the development of VTE is thought to occur in the context of omitted prophylaxis.
Objectives: To describe hospitalized patients who develop VTE and to determine whether they received antecedent prophylaxis.
Design: Case series.
Setting: Brigham and Women’s Hospital.
Patients: Three hundred eighty-four patients who developed in-hospital deep venous thrombosis or pulmonary embolism or who developed VTE within 30 days of prior hospital discharge.
Main outcome measures: The relationship of developing new-onset VTE to the use or omission of antecedent in-hospital prophylaxis.
Results: Of the 384 identified patients, 272 had deep venous thrombosis alone, 62 had pulmonary embolism alone, and 50 had deep venous thrombosis and pulmonary embolism. Most were medical service patients; fewer than one fourth were general or orthopedic surgery patients. Overall, 52% had received antecedent VTE prophylaxis. Thirteen deaths (3.4%) were ascribed to pulmonary embolism, and prophylaxis was omitted in only 1 of those 13 patients.
Conclusions: Most deaths from pulmonary embolism among patients hospitalized for other conditions occurred in the setting of failed prophylaxis rather than omitted prophylaxis. High-risk patients, especially medical service patients, warrant intensive VTE prophylaxis and close follow-up to ensure successful outcomes.
Key Words: prophylaxis • pulmonary embolism • venous thromboembolism
This article has been cited by other articles:
|
|
 |
|
  F. Dentali, J. D. Douketis, M. Gianni, W. Lim, and M. A. Crowther Meta-analysis: Anticoagulant Prophylaxis to Prevent Symptomatic Venous Thromboembolism in Hospitalized Medical Patients Ann Intern Med, February 20, 2007; 146(4): 278 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. Spyropoulos Introduction. Am. J. Health Syst. Pharm., October 15, 2006; 63(20 Suppl 6): S3 - S4. [Full Text] [PDF]
|
|
|
|
 |
|
 S T Rashid, M R Thursz, N A Razvi, R Voller, T Orchard, S T Rashid, and A A Shlebak Venous thromboprophylaxis in UK medical inpatients J R Soc Med, November 1, 2005; 98(11): 507 - 512. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Kucher, S. Koo, R. Quiroz, J. M. Cooper, M. D. Paterno, B. Soukonnikov, and S. Z. Goldhaber Electronic Alerts to Prevent Venous Thromboembolism among Hospitalized Patients N. Engl. J. Med., March 10, 2005; 352(10): 969 - 977. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Z. Goldhaber and A. G.G. Turpie Prevention of Venous Thromboembolism Among Hospitalized Medical Patients Circulation, January 4, 2005; 111(1): e1 - e3. [Full Text] [PDF]
|
|
|
|
|
|
A. Leizorovicz and P. Mismetti Preventing Venous Thromboembolism in Medical Patients Circulation, December 14, 2004; 110(24_suppl_1): IV-13 - IV-19. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Leizorovicz, A. T. Cohen, A. G.G. Turpie, C.-G. Olsson, P. T. Vaitkus, S. Z. Goldhaber, and for the PREVENT Medical Thromboprophylaxis Study G Randomized, Placebo-Controlled Trial of Dalteparin for the Prevention of Venous Thromboembolism in Acutely Ill Medical Patients Circulation, August 17, 2004; 110(7): 874 - 879. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Rascona Prevention of Fatal Pulmonary Embolism in the Hospital Chest, April 1, 2004; 125(4): 1595 - 1596. [Full Text] [PDF]
|
|
|
|
|
|
S. Z. Goldhaber and C. G. Elliott Acute Pulmonary Embolism: Part II: Risk Stratification, Treatment, and Prevention Circulation, December 9, 2003; 108(23): 2834 - 2838. [Full Text] [PDF]
|
|
|
|
 |
|
 J. B Groce Comment: venous thromboembolism prophylaxis conversion in nonsurgical inpatients Ann. Pharmacother., December 1, 2003; 37(12): 1915 - 1916. [Full Text] [PDF]
|
|
|
|
 |
|
 K. T. Horlander, D. M. Mannino, and K. V. Leeper Pulmonary Embolism Mortality in the United States, 1979-1998: An Analysis Using Multiple-Cause Mortality Data Arch Intern Med, July 28, 2003; 163(14): 1711 - 1717. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Arnold, S. R. Kahn, and I. Shrier Missed Opportunities for Prevention of Venous Thromboembolism : An Evaluation of the Use of Thromboprophylaxis Guidelines Chest, December 1, 2001; 120(6): 1964 - 1971. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
