Author + information
- Rahul Chaudhary,
- Bhavina Batukbhai,
- Martin Sanchez,
- Malini Chandra Serharan,
- Eric Feng,
- Charles R. Albrecht III and
- Mauro Moscucci
Background: Guidelines for venous thromboembolism (VTE) prophylaxis recommend appropriate risk stratification followed by institution of chemical or mechanical prophylaxis at the time of admission, change of level of care and discharge. No role of re-assessment of VTE risk at regular intervals has been described in patients without a change in level of care.
Methods: We conducted a retrospective chart review of 170 consecutive patients from January 1, 2015 to March 1, 2015 admitted to general medical floors with a hospital stay more than 3 days. Patients on surgical service, prior anticoagulation and previous diagnosis of VTE were excluded. Individual patient's risk for VTE was calculated using the Padua prediction score at the time of admission and it was calculated again at Day 3 following admission for any change. Reassessment at Day 3 was chosen as 3 risk factors in the Padua risk score including heart failure, acute myocardial infarction and acute infection could potentially change over a 3 day time period.
Results: The risk score calculated was significantly different between day 1 and day 3 (4.7±1.7 vs. 4.2±1.8 respectively; p=0.004). All the patients with low-risk on day 1 remained at low-risk on day 3. However, 17.2% patients at high risk on day 1 were re-stratified as low risk on day 3 (p<0.001). No patients changed from a low- to high risk score at day 3. The re-assessment could have reduced 69 additional days of chemical prophylaxis in 23 patients.
Conclusions: Our study suggests that VTE risk can be a changing parameter that needs to be re-assessed at regular intervals during the same hospitalization, even in the absence of changes in level of care.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Diabetes and Other Issues in Cardiovascular Prevention
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1277-058
- 2017 American College of Cardiology Foundation