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Venous thromboembolism prophylaxis and clinical consequences in medically ill patients.
[acute rheumatic fever]
The
objective
of
this
study
was
to
examine
venous
thromboembolism
(
VTE
)
prophylaxis
use
,
risk
reduction
,
and
readmission
in
medically
ill
patients
during
hospitalization
and
after
discharge
.
This
5
-
year
retrospective
study
linked
outpatient
files
from
MarketScan
Commercial
and
Medicare
Supplemental
databases
.
Patients
were
categorized
into
prophylaxis
and
non-prophylaxis
groups
based
on
guideline-recommended
anticoagulant
use
from
the
index
date
to
180
days
posthospital
discharge
and
before
the
first
VTE
event
date
.
Outcome
variables
were
VTE
events
and
rehospitalization
.
Risk
adjustment
was
conducted
within
the
prophylaxis
group
and
between
the
prophylaxis
and
non-prophylaxis
groups
using
propensity
score
matching
.
Among
4467
patients
,
28
.
99
%
of
the
patients
(
n
=
1295
)
were
admitted
with
cancer
,
18
.
03
%
(
n
=
805
)
with
pneumonia
,
14
.
06
%
(
n
=
628
)
with
heart
failure
,
11
.
06
%
(
n
=
494
)
with
stroke
,
11
.
11
%
(
n
=
496
)
with
sepsis
,
8
.
08
%
(
n
=
361
)
with
infectious
diseases
,
5
.
6
%
(
n
=
250
)
with
severe
respiratory
disorders
,
1
.
81
%
(
n
=
81
)
with
inflammatory
bowel
disease
,
1
.
05
%
(
n
=
47
)
with
obesity
,
0
.
20
%
(
n
=
9
)
with
neurologic
disorders
,
and
0
.
02
%
(
n
=
1
)
with
acute
rheumatic
fever
.
Among
those
with
180
-
day
continuous
enrollment
after
the
index
date
(
n
=
3511
)
,
51
.
81
%
(
n
=
1819
)
received
anticoagulant
therapy
only
,
2
.
48
%
(
n
=
87
)
received
mechanical
compression
treatment
only
(
stocking
or
pneumatic
compression
)
,
and
4
.
41
%
(
n
=
155
)
received
both
during
hospitalization
.
Anticoagulant
therapy
rates
ranged
from
88
.
64
%
(
obesity
)
to
32
.
39
%
(
inflammatory
bowel
disease
)
.
Among
anticoagulant
therapy
patients
,
740
patients
(
40
.
68
%
)
received
low
-molecular
weight
heparin
only
and
806
patients
(
44
.
31
%
)
received
unfractionated
heparin
.
After
risk
adjustment
,
compared
with
patients
without
VTE
prophylaxis
,
anticoagulant
prophylaxis
patients
had
lower
VTE
(
3
.
62
%
vs
.
4
.
27
%
,
P
<
0
.
04
)
and
readmission
rates
(
24
.
22
%
vs
.
27
.
95
%
,
P
<
0
.
02
)
during
the
6
months
post-index
hospital
admission
.
In
conclusion
anticoagulant
prophylaxis
is
underutilized
and
is
associated
with
reduced
VTE
risk
and
a
decrease
in
rehospitalizations
for
medically
ill
patients
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated