Interventions for implementation of thromboprophylaxis in hospitalized patients at risk for venous thromboembolism.

CONCLUSIONS: We reviewed RCTs that implemented a variety of system-wide strategies aimed at improving thromboprophylaxis in hospitalized patients. We found increased prescription of prophylaxis associated with alerts and multifaceted interventions, and increased prescription of appropriate prophylaxis associated with alerts. While multifaceted interventions were found to be less effective than alerts, a multifaceted intervention with an alert was more effective than one without an alert. Alerts, particularly computer alerts, were associated with a reduction in symptomatic VTE at three months, although there were not enough studies to pool computer alerts and human alerts results separately.Our analysis was underpowered to assess the effect on mortality and safety outcomes, such as bleeding.The incomplete reporting of relevant study design features did not allow complete assessment of the certainty of the evidence. However, the certainty of the evidence for improvement in outcomes was judged to be better than for our previous review (low- to moderate-certainty evidence, compared to very low-certainty evidence for most outcomes). The results of our updated review will help physicians, hospital administrators, and policy makers make practical decisions about adopting specific system-wide measures to improve prescription of thromboprophylaxis, and ultimately prevent VTE in hospitalized patients. PMID: 29687454 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research

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Authors: Ichikawa T, Machida N, Kaneko H, Oi I, A Fujino M Abstract Objective The aim of this study was to identify patients with a high risk of early mortality after acute esophageal variceal bleeding by measuring the C-reactive protein (CRP) level. Methods We retrospectively evaluated 154 consecutive cirrhotic patients admitted with esophageal variceal bleeding. Differences between categorical variables were assessed by the chi-square test. Continuous variables were compared using the Mann-Whitney U-test. Multivariate logistic regression analyses consisting of clinical laboratory parameters were performed to iden...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
Conclusions: UFH with sequential enoxaparin has similar anticoagulant effect and safety as UFH in PCI of complex coronary artery disease. PMID: 30334526 [PubMed - in process]
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
AbstractVenous thromboembolism (VTE) is a multifactorial disease. Cancer and older age are risk factors for both recurrent VTE and bleeding under anticoagulant therapy. Oral direct factor Xa inhibitors (Xa inhibitors) have been widely used to treat VTE. However, their effectiveness and safety in cancer and elderly patients have not been fully elucidated. A total of 187 consecutive patients who started Xa inhibitors for VTE therapy between September 2014 and September 2016 were recruited. Patients ’ demographics, changes in VTE amount, VTE recurrence, clinically relevant bleeding, and death until February 2017 were co...
Source: Heart and Vessels - Category: Cardiology Source Type: research
This article provides an overview of betrixaban’s pharmacological profile, clinical trial results, and potential roles in therapy.
Source: Cardiology in Review - Category: Cardiology Tags: New Therapy Update Source Type: research
ConclusionMultimodal VTE prophylaxis demonstrated a low rate of proximal DVT, PE and bleeding complications. The rate of asymptomatic DVT was high, but most were distal and unlikely to be clinically significant. Patients with diabetes and those receiving TKA could be at higher risk of asymptomatic DVT, and may benefit from closer clinical assessment. These findings suggest aspirin is safe and efficacious when used in combination with mechanical compressors and early mobilisation. However, our findings require further validation, particularly with larger, prospective comparative studies.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
Hemostasis, endowed to human to protect lives, is a process of logical blood clotting system to prevent blood loss in vascular injury. However, the notion that deadly thrombosis occurs as a result of normal hemostasis in intravascular injury could encounter with conceptual skepticism because the term ‘thrombosis’ automatically conjures up as serious disease. According to ‘two-path unifying theory’, normal hemostasis is initiated only by vascular injury through activated unusually large von Willebrand factor (ULVWF) path and/or activated tissue factor (TF) path. When these two equally important paths...
Source: Blood Coagulation and Fibrinolysis - Category: Hematology Tags: REVIEW ARTICLES Source Type: research
European Journal of Haematology,Volume 0, Issue ja, -Not available-.
Source: European Journal of Haematology - Category: Hematology Authors: Source Type: research
Abstract The prevention of atherothrombotic events is an essential therapeutic goal in the treatment of patients with arteriosclerotic diseases. After plaque rupture, a rapidly growing thrombus can lead to acute vascular occlusion and thus heart attack, stroke or limb ischaemia. The acute therapy combines anticoagulation and platelet inhibition. However, the only available therapy so far in the primary and secondary prevention of stable patients is the platelet inhibitors aspirin and clopidogrel. Despite the use of antiplatelet therapies, including aspirin and P2Y12-receptor antagonists, some patients with artery ...
Source: Hamostaseologie - Category: Hematology Authors: Tags: Hamostaseologie Source Type: research
We report the case of acute arterial occlusion secondary to a leukoblastic embolus causing limb threatening ischemia in a patient with acute myelogenous leukemia. The patient was successfully treated surgically by open superficial femoral artery thrombectomy, common femoral endarterectomy with patch angioplasty, and percutaneous tibial embolectomy.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Source Type: research
CONCLUSION:  Donor platelets enhance reversal of the anti-aggregant effect of ticagrelor in vitro. Donor platelets given in clinically relevant amounts partially reversed ticagrelor at 10 hours after the last dose, and almost fully reversed ticagrelor at 24 hours. The results inform on the potential to reverse ticagrelor in patients who develop bleeding or require emergency surgery. PMID: 30332695 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
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