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
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Diseases presenting "18" symptom

acute rheumatic fever

allergic bronchopulmonary aspergillosis

scrub typhus

von hippel-lindau disease

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