PB1476 - Occurrence of hospital-associated thrombosis despite thromboprophylaxis in the setting of current thromboprophylaxis strategies: an observational cross-sectional study

Tuesday, June 27, 2023

18:30 – 19:30 ET

Room: Exhibition

Presenting Author(s)

Chantal Visser, MD

PhD candidate, MD
Department of Hematology, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
Rotterdam, Zuid-Holland, Netherlands

Co-Author(s)

MK

Marieke J.H.A. Kruip

Associate professor, hematologist, MD, PhD
Department of Hematology, Erasmus MC, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
Rotterdam, Zuid-Holland, Netherlands
JB

Janet Brantsma - van der Graaf

Nurse practicioner
Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
Dordrecht, Zuid-Holland, Netherlands
ML

Mark-David Levin

Hematologist, MD, PhD
Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
Dordrecht, Zuid-Holland, Netherlands
ET

Eric Thiel, van

Pulmonologist, MD, PhD
Department of Pulmonology, Albert Schweitzer Hospital, Dordrecht, The Netherlands
Dordrecht, Zuid-Holland, Netherlands
PW

Peter Westerweel

Hematologist, MD, PhD
Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
Dordrecht, Zuid-Holland, Netherlands

Background: Hospital-associated thrombosis (HAT) is a common potentially preventable cause of morbidity and mortality. Thromboprophylaxis can effectively lower the risk of thrombosis in hospitalized patients. Most HAT improvement programs have focused on increasing the adherence to thromboprophylaxis guidelines. Subsequently, low adherence is commonly believed to be the cause of the development of HAT, even though thromboprophylaxis reduces the risk of HAT by up to 80%.

Aims: To describe the proportion of HAT patients who developed HAT despite correctly applied thromboprophylaxis strategy.

Methods: In this cross-sectional study, we included patients with a venous thrombotic event (VTE) diagnosed during a 3-year period and assessed the proportion of HAT patients in whom the thromboprophylaxis strategies was correctly applied. HAT patients were divided into low risk (should not receive thromboprophylaxis because of a low a priori risk) and high risk (should receive thromboprophylaxis because of a higher a prior risk). The local institutional review board approved this study and waived requirement of written informed consent.

Results: Of 1164 patients diagnosed with VTE, 187 patients experienced a HAT. The median age [interquartile range (IQR)] was 67 [25] years, 52.4% (89/187) was female and 62.6% (117/187) was categorized as high risk. The correct thromboprophylaxis strategy was applied in 80.7% (151/187) of HAT patients [Table 1]. Of the 117 high-risk patients, 93 (79.5%) received thromboprophylaxis. Of the 70 low-risk patients, 10 (14.3%) received thromboprophylaxis. In 68.0% (70/103) of the patients who received thromboprophylaxis, the HAT was diagnosed after discontinuation, with a median [IQR] of 15.4 [32.2] days after discontinuation [Figure 1].

Conclusion(s): HAT remains a prominent clinical problem in our patient population, despite the appropriate application of thromboprophylaxis strategies. A high proportion of HAT patients who received thromboprophylaxis were diagnosed with VTE after discontinuation. Additional strategies may focus on patients who require extended periods of thromboprophylaxis.