PURPOSE: Acute and chronic lung diseases are recognized to be high risk factors for the development of deep vein thrombosis (DVT). In the current analysis, the real-world use of DVT prophylaxis and rates of DVT and pulmonary embolism (PE) were assessed in-hospital and then followed post-discharge in US patients with severe lung diseases.
METHODS: Data were extracted from the US Premier Perspective(tm)-i3 Pharma Informatics linked database for patients with ICD-9 codes for severe lung disease (including chronic obstructive pulmonary disease, acute bronchitis and bronchiolitis, pneumonia, and pneumoconiosis) and who were admitted January 2005 through November 2007. Included patients were aged ≥ 18 years and had at least 6 months’ continuous plan enrollment. Patients were excluded if they were discharged to an acute-care facility, had length of hospital stay ≤ 0 or > 30 days, had missing/unknown gender or age data, or if they were diagnosed with atrial fibrillation. Clinical rates of DVT/PE, as well as provision of thromboprophylaxis were evaluated for inpatients and assessed post-discharge.
RESULTS: Of the 5,141 patients with severe lung disease analyzed, 38% received inpatient pharmacological or mechanical thromboprophylaxis and 2.4% received outpatient pharmacological prophylaxis in the 14 days following discharge. Mean ± standard deviation duration of prophylaxis was 1.4 ± 2.7 days for inpatients and 0.6 ± 4.3 days post-discharge, with a total duration of 2.1 ± 5.2 days. Symptomatic DVT/PE occurred in 3.0% of patients during index hospitalization and in 0.9% of patients in the 30 days following hospital discharge.
CONCLUSION: This real-world analysis demonstrates the considerable rates of DVT/PE in hospitalized patients with severe lung disease. Nearly two-thirds of inpatients received no pharmacological or mechanical thromboprophylaxis. Few patients received post-discharge pharmacological prophylaxis and prophylaxis duration was generally short.
CLINICAL IMPLICATIONS: Further efforts are needed to ensure that all patients with severe lung disease receive appropriate thromboprophylaxis and that it is of adequate duration to reduce the burden of DVT.
DISCLOSURE: Alpesh Amin, Grant monies (from industry related sources) Alpesh Amin has received research honorarium from sanofi-aventis U.S. Inc. and Boehringer-Ingelheim. Daniel Wiederkehr is an employee of Quintiles Consulting, which has received research grants from sanofi-aventis, US Inc. Jay Lin is an employee at Bruce Wong &Associates, Inc., which has received funding to carry out this work from sanofi-aventis U.S., Inc.; Employee Stephen Thompson is an employee of sanofi-aventis US, Inc.; Consultant fee, speaker bureau, advisory committee, etc. Alpesh Amin is on the speakers bureau for sanofi-aventis U.S. Inc.; Other The authors received editorial/writing support in the preparation of this abstract funded by sanofi-aventis U.S., Inc.; No Product/Research Disclosure Information