Prophylaxis of Venous Thromboembolism after Hospital Discharge in Internal Medicine: Findings from the Observational FADOI-NoTEVole Study.


Journal

Thrombosis and haemostasis
ISSN: 2567-689X
Titre abrégé: Thromb Haemost
Pays: Germany
ID NLM: 7608063

Informations de publication

Date de publication:
Dec 2019
Historique:
pubmed: 22 10 2019
medline: 10 7 2020
entrez: 22 10 2019
Statut: ppublish

Résumé

 Post-discharge prophylaxis for venous thromboembolism (VTE) is a challenging issue in patients hospitalised in Internal Medicine Units (IMUs). The aim of this study was to evaluate the frequency and the factors associated with post-discharge prophylaxis for VTE in IMUs.  Multi-centre, retrospective study including consecutive patients who were admitted for any cause and discharged from an IMU.  Overall, 3,740 patients (mean age 74.1 ± 15.7 years) were included in the study at 38 IMUs in Italy. At discharge, the percentage of patients receiving pharmacological thromboprophylaxis was 16.0% (20.1% after excluding patients treated with anticoagulants for indications other than VTE prophylaxis). At multivariable analysis, history of ischaemic stroke, hypomobility ≥ 7 days, central venous catheter, ≥ 10 versus ≤ 5 days of hospital stay, use of corticosteroids, cancer, history of falls, availability of a caregiver, infections and age were significantly associated with thromboprophylaxis, while an inverse correlation was observed with concomitant anti-platelet drugs and platelet count < 70,000/mm  In this study, one in five patients discharged from an Italian IMU received prophylaxis for VTE. The perceived thrombotic risk is significantly related to the use of prophylaxis.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
 Post-discharge prophylaxis for venous thromboembolism (VTE) is a challenging issue in patients hospitalised in Internal Medicine Units (IMUs). The aim of this study was to evaluate the frequency and the factors associated with post-discharge prophylaxis for VTE in IMUs.
METHODS METHODS
 Multi-centre, retrospective study including consecutive patients who were admitted for any cause and discharged from an IMU.
RESULTS RESULTS
 Overall, 3,740 patients (mean age 74.1 ± 15.7 years) were included in the study at 38 IMUs in Italy. At discharge, the percentage of patients receiving pharmacological thromboprophylaxis was 16.0% (20.1% after excluding patients treated with anticoagulants for indications other than VTE prophylaxis). At multivariable analysis, history of ischaemic stroke, hypomobility ≥ 7 days, central venous catheter, ≥ 10 versus ≤ 5 days of hospital stay, use of corticosteroids, cancer, history of falls, availability of a caregiver, infections and age were significantly associated with thromboprophylaxis, while an inverse correlation was observed with concomitant anti-platelet drugs and platelet count < 70,000/mm
CONCLUSION CONCLUSIONS
 In this study, one in five patients discharged from an Italian IMU received prophylaxis for VTE. The perceived thrombotic risk is significantly related to the use of prophylaxis.

Identifiants

pubmed: 31634959
doi: 10.1055/s-0039-1697661
doi:

Substances chimiques

Adrenal Cortex Hormones 0
Anticoagulants 0
Platelet Aggregation Inhibitors 0

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

2043-2052

Informations de copyright

Georg Thieme Verlag KG Stuttgart · New York.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Alessandro Squizzato (A)

Department of Internal Medicine, University of Insubria, Varese, Italy.

Giancarlo Agnelli (G)

Department of Internal and Cardiovascular Medicine-Stroke Unit, Hospital "S. Maria della Misericordia," University of Perugia, Perugia, Italy.

Mauro Campanini (M)

Department of Internal Medicine, Hospital "Maggiore della Carità," Novara, Italy.

Francesco Dentali (F)

Department of Internal Medicine, Hospital of Luino, ASST-Sette Laghi, University of Insubria, Varese, Italy.

Francesca Agnelli (F)

Department of Internal Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Erminio Bonizzoni (E)

Department of Clinical Science and Community, Section of Medical Statistics, Biometry and Epidemiology, Faculty of Medicine and Surgery, University of Milan, Milan, Italy.

Alessandro Franco (A)

Department of Internal Medicine, Hospital "L. Parodi Delfino," Colleferro, Rome, Italy.

Andrea Gallo (A)

Department of Internal Medicine, University of Insubria, Varese, Italy.

Gualberto Gussoni (G)

Department of Research, FADOI Foundation, Milan, Italy.

Cinzia Nitti (C)

Department of Emergency Medicine, AOU Hospital, Ancona, Italy.

Giuseppa Triolo (G)

Department of Internal Medicine, Hospital "Villa Sofia," Palermo, Italy.

Antonella Valerio (A)

Department of Research, FADOI Foundation, Milan, Italy.

Francesco Ventrella (F)

Department of Internal Medicine, Hospital "G. Tatarella"- ASL-FG, Cerignola, FG, Italy.

Andrea Fontanella (A)

Department of Medical, Hospital "Buon Consiglio-Fatebenefratelli," Naples, Italy.

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