0
Abstract: Slide Presentations |

RISK PROFILES AND PROPHYLAXIS HISTORY OF PATIENTS DEVELOPING VENOUS THROMBOEMBOLISM IN THE OUTPATIENT SETTING: THE WORCESTER VENOUS THROMBOEMBOLISM STUDY FREE TO VIEW

Frederick A. Spencer, MD*; Cathy Emery, RN; Darleen Lessard, MPH; Frederick A. Anderson, PhD; Sri Emani, MPH; Richard C. Becker, MD; Robert J. Goldberg, PhD
Author and Funding Information

University of Massachusetts Medical Center, Worcester, MA


Chest


Chest. 2005;128(4_MeetingAbstracts):192S. doi:10.1378/chest.128.4_MeetingAbstracts.192S
Text Size: A A A
Published online

Abstract

PURPOSE:  Considerable emphasis has been placed on improving the identification of hospitalized patients at high risk for venous thromboembolism (VTE) so that they receive adequate prophylaxis. However increased availability of outpatient procedures, increased utilization of in-dwelling catheters, and shortened length of hospital stay might be expected to lead to an increasing outpatient population that is also high risk for VTE. The purpose of this study was to compare risk factor profile, previous VTE prophylaxis use, and outcomes of patients who developed VTE in the outpatient setting versus those who developed VTE after admission for another non-VTE related diagnosis.

METHODS:  The medical records of all residents from the Worcester,MA area (2000 census=478,000) diagnosed with ICD-9 codes consistent with possible VTE at all 11 Worcester hospitals in 1999 are being reviewed by trained data abstractors. Validation of each case of VTE is performed using prespecified criteria. Information was collected about demographic and clinical characteristics, prior VTE prophylaxis, and hospital outcomes.

RESULTS:  A total of 587 cases have been validated as acute VTE events for the year 1999. We present an interim analysis based on data from the first 392 cases enrolled. See Table 1 for characteristics of these patients stratified by setting of VTE development.

CONCLUSION:  Patients who develop VTE in the outpatient setting were younger, more often female, and more likely to be on hormonal therapy than those who developed VTE during a hospitalization. They were just as likely to have a history of prior VTE, recent hospitalization or surgery, recent fracture, or recent cancer/chemotherapy. Utilization of prophylaxis (particularly anticoagulant) was suboptimal in patients who developed VTE during a hospitalization. It also was suboptimal after recent surgery or during prior hospitalizations in patients who developed VTE in the outpatient setting.

CLINICAL IMPLICATIONS:  These data suggest that patients who develop VTE as outpatients have a high prevalence of risk factors, including recent surgery and/or hospitalization. Further research on the optimal identification of these high-risk patients and targetted outpatient VTE prophylaxis is warranted.

DISCLOSURE:  Frederick Spencer, None.

12:30 PM - 2:00 PM


Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543