Evidence map›Paper›PMID 39260742›Full record

ArticleJournal of thrombosis and haemostasis : JTH2024

Factors associated with venous thromboembolism pharmacoprophylaxis initiation in hospitalized medical patients: the Medical Inpatients Thrombosis and Hemostasis study.

Allen B Repp, Andrew D Sparks, Katherine Wilkinson, Nicholas S Roetker, Jordan K Schaefer, Ang Li, Leslie A McClure, Deirdra R Terrell, Augusto Ferraris, Alys Adamski and 2 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of thrombosis and haemostasis : JTH, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Allen B ReppDepartment of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA; Department of Medicine, University of Vermont Medical Center, Burlington, Vermont, USA. Electronic address: allen.repp@uvmhealth.org.
Andrew D SparksDepartment of Medical Biostatistics, University of Vermont, Burlington, Vermont, USA.
Katherine WilkinsonDepartment of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA.
Nicholas S RoetkerDepartment of Medicine, Hennepin Healthcare & Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA.
Jordan K SchaeferDepartment of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Ang LiSection of Hematology-Oncology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Leslie A McClureDepartment of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania, USA; Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri, USA.
Deirdra R TerrellDepartment of Biostatistics & Epidemiology, Hudson College of Public Health, Oklahoma City, Oklahoma, USA.
Augusto FerrarisDepartment of Epidemiology, University of Washington, Seattle, Washington, USA.
Alys AdamskiDivision of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Nicholas L SmithDepartment of Epidemiology, University of Washington, Seattle, Washington, USA; Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs, Office of Research and Development, Seattle, Washington, USA.
Neil A ZakaiDepartment of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA; Department of Medicine, University of Vermont Medical Center, Burlington, Vermont, USA; Department of Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA.

Funding

Thrombosis and Bleeding Risk Assessment in Medical InpatientsR01HL141290 · NHLBI · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI Deirdra R Terrell, Neil Adrian Zakai · 2019 to 2026
$3.5M
An Intervention to Reduce Cancer Associated Thrombosis Through Improved ProphylaxisK01HL169920 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jordan Schaefer · 2023 to 2026
$684k
Intramural CDC HHS CC999999NHLBI NIH HHS K01 HL169920NHLBI NIH HHS R01 HL141290
6 · The paper itself

Abstract

backgroundAlthough guidelines recommend risk assessment for hospital-acquired venous thromboembolism (HA-VTE) to inform prophylaxis decisions, studies demonstrate inappropriate utilization of pharmacoprophylaxis in hospitalized medical patients. Predictors of pharmacoprophylaxis initiation in medical inpatients remain largely unknown.

objectivesTo determine factors associated with HA-VTE pharmacoprophylaxis initiation in adults hospitalized on medical services.

methodsWe performed a cohort study using electronic health record data from adult patients hospitalized on medical services at 4 academic medical centers between 2016 and 2019. Main measures were candidate predictors of HA-VTE pharmacoprophylaxis initiation, including known HA-VTE risk factors, predicted HA-VTE risk, and bleeding diagnoses present on admission.

resultsAmong 111 550 admissions not on intermediate or full-dose anticoagulation, 48 520 (43.5%) received HA-VTE pharmacoprophylaxis on the day of or the day after admission. After adjustment for age, sex, race/ethnicity, and study site, the strongest clinical predictors of HA-VTE pharmacoprophylaxis initiation were malnutrition and chronic obstructive pulmonary disease. Thrombocytopenia and history of gastrointestinal bleeding were associated with decreased odds of HA-VTE pharmacoprophylaxis initiation. Patients in the highest 2 tertiles of predicted HA-VTE risk were less likely to receive HA-VTE pharmacoprophylaxis than patients in the lowest (first) tertile (OR, 0.84; 95% CI, 0.81-0.86 for the second tertile; OR, 0.95; 95% CI, 0.92-0.98 for the third tertile).

conclusionAmong patients not already receiving anticoagulants, HA-VTE pharmacoprophylaxis initiation during the first 2 hospital days was lower in patients with a higher predicted HA-VTE risk and those with risk factors for bleeding. Reasons for not initiating pharmacoprophylaxis in those with a higher predicted HA-VTE risk could not be assessed.

Indexed as

AnticoagulantsHospitalizationInpatientsVenous ThromboembolismAcademic Medical CentersAdultAgedAged, 80 and overElectronic Health RecordsFemaleHemorrhageHemostasisHumansMaleMiddle AgedRisk AssessmentAnticoagulantsanticoagulantshealthcare disparitieshospitalizationrisk factorsvenous thromboembolism

Identifiers

PMID39260742
PMCPMC11608142

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.