Thromboembolism prophylaxis in end-stage renal disease

Georgene W. Hergenroeder, Robert L. Levine, Charles C. Miller

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVE: This study aimed to identify risk for venous thromboembolism (VTE) and prophylaxis patterns for endstage renal disease (ESRD) patients admitted through the emergency department (ED). METHODS: ESRD patients admitted through the ED in an urban teaching hospital were enrolled in this observational cohort. Admissions through the ED were reviewed as part of a VTE prophylaxis utilization analysis. Patients with moderate to high risk for VTE based on a modified risk assessment model were considered in need of prophylaxis. Prophylaxis was defined as medical (heparin/low-molecular-weight heparin) or mechanical prophylaxis. Readmissions during the following year were monitored through an electronic database for thrombosis-related International Classification of Diseases, Ninth Revision codes. RESULTS: Thirty patients met enrollment criteria. Twenty of the 30 patients (67%) were at moderate or higher risk for VTE and considered in need of VTE prophylaxis; 6 patients (30%) were actively prophylaxed. High risk was associated with a lower probability of appropriate prophylaxis (p <0.04). Three patients (10%) had a clotting-related outcome. CONCLUSIONS: The 30% rate of VTE prophylaxis in the ESRD group is consistent with the general prophylaxis rate. Lower-risk patients appropriately received no treatment, whereas treatment was omitted in high-risk ESRD patients. The observed rate of 10% thrombosis-related diagnoses may underestimate the actual thrombosis rate.

Original languageEnglish
Pages (from-to)439-444
Number of pages6
JournalDialysis and Transplantation
Volume37
Issue number11
DOIs
StatePublished - Nov 1 2008

Fingerprint

Thromboembolism
Chronic Kidney Failure
Venous Thromboembolism
Kidney
Hospital Emergency Service
Thrombosis
Low Molecular Weight Heparin
Urban Hospitals
International Classification of Diseases
Teaching Hospitals
Heparin
Databases
Therapeutics

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Hergenroeder, G. W., Levine, R. L., & Miller, C. C. (2008). Thromboembolism prophylaxis in end-stage renal disease. Dialysis and Transplantation, 37(11), 439-444. https://doi.org/10.1002/dat.20280

Thromboembolism prophylaxis in end-stage renal disease. / Hergenroeder, Georgene W.; Levine, Robert L.; Miller, Charles C.

In: Dialysis and Transplantation, Vol. 37, No. 11, 01.11.2008, p. 439-444.

Research output: Contribution to journalArticle

Hergenroeder, GW, Levine, RL & Miller, CC 2008, 'Thromboembolism prophylaxis in end-stage renal disease', Dialysis and Transplantation, vol. 37, no. 11, pp. 439-444. https://doi.org/10.1002/dat.20280
Hergenroeder, Georgene W. ; Levine, Robert L. ; Miller, Charles C. / Thromboembolism prophylaxis in end-stage renal disease. In: Dialysis and Transplantation. 2008 ; Vol. 37, No. 11. pp. 439-444.
@article{3b5358733be1438d871908665ed6e8da,
title = "Thromboembolism prophylaxis in end-stage renal disease",
abstract = "OBJECTIVE: This study aimed to identify risk for venous thromboembolism (VTE) and prophylaxis patterns for endstage renal disease (ESRD) patients admitted through the emergency department (ED). METHODS: ESRD patients admitted through the ED in an urban teaching hospital were enrolled in this observational cohort. Admissions through the ED were reviewed as part of a VTE prophylaxis utilization analysis. Patients with moderate to high risk for VTE based on a modified risk assessment model were considered in need of prophylaxis. Prophylaxis was defined as medical (heparin/low-molecular-weight heparin) or mechanical prophylaxis. Readmissions during the following year were monitored through an electronic database for thrombosis-related International Classification of Diseases, Ninth Revision codes. RESULTS: Thirty patients met enrollment criteria. Twenty of the 30 patients (67{\%}) were at moderate or higher risk for VTE and considered in need of VTE prophylaxis; 6 patients (30{\%}) were actively prophylaxed. High risk was associated with a lower probability of appropriate prophylaxis (p <0.04). Three patients (10{\%}) had a clotting-related outcome. CONCLUSIONS: The 30{\%} rate of VTE prophylaxis in the ESRD group is consistent with the general prophylaxis rate. Lower-risk patients appropriately received no treatment, whereas treatment was omitted in high-risk ESRD patients. The observed rate of 10{\%} thrombosis-related diagnoses may underestimate the actual thrombosis rate.",
author = "Hergenroeder, {Georgene W.} and Levine, {Robert L.} and Miller, {Charles C.}",
year = "2008",
month = "11",
day = "1",
doi = "10.1002/dat.20280",
language = "English",
volume = "37",
pages = "439--444",
journal = "Dialysis and Transplantation",
issn = "0090-2934",
publisher = "John Wiley and Sons Inc.",
number = "11",

}

TY - JOUR

T1 - Thromboembolism prophylaxis in end-stage renal disease

AU - Hergenroeder, Georgene W.

AU - Levine, Robert L.

AU - Miller, Charles C.

PY - 2008/11/1

Y1 - 2008/11/1

N2 - OBJECTIVE: This study aimed to identify risk for venous thromboembolism (VTE) and prophylaxis patterns for endstage renal disease (ESRD) patients admitted through the emergency department (ED). METHODS: ESRD patients admitted through the ED in an urban teaching hospital were enrolled in this observational cohort. Admissions through the ED were reviewed as part of a VTE prophylaxis utilization analysis. Patients with moderate to high risk for VTE based on a modified risk assessment model were considered in need of prophylaxis. Prophylaxis was defined as medical (heparin/low-molecular-weight heparin) or mechanical prophylaxis. Readmissions during the following year were monitored through an electronic database for thrombosis-related International Classification of Diseases, Ninth Revision codes. RESULTS: Thirty patients met enrollment criteria. Twenty of the 30 patients (67%) were at moderate or higher risk for VTE and considered in need of VTE prophylaxis; 6 patients (30%) were actively prophylaxed. High risk was associated with a lower probability of appropriate prophylaxis (p <0.04). Three patients (10%) had a clotting-related outcome. CONCLUSIONS: The 30% rate of VTE prophylaxis in the ESRD group is consistent with the general prophylaxis rate. Lower-risk patients appropriately received no treatment, whereas treatment was omitted in high-risk ESRD patients. The observed rate of 10% thrombosis-related diagnoses may underestimate the actual thrombosis rate.

AB - OBJECTIVE: This study aimed to identify risk for venous thromboembolism (VTE) and prophylaxis patterns for endstage renal disease (ESRD) patients admitted through the emergency department (ED). METHODS: ESRD patients admitted through the ED in an urban teaching hospital were enrolled in this observational cohort. Admissions through the ED were reviewed as part of a VTE prophylaxis utilization analysis. Patients with moderate to high risk for VTE based on a modified risk assessment model were considered in need of prophylaxis. Prophylaxis was defined as medical (heparin/low-molecular-weight heparin) or mechanical prophylaxis. Readmissions during the following year were monitored through an electronic database for thrombosis-related International Classification of Diseases, Ninth Revision codes. RESULTS: Thirty patients met enrollment criteria. Twenty of the 30 patients (67%) were at moderate or higher risk for VTE and considered in need of VTE prophylaxis; 6 patients (30%) were actively prophylaxed. High risk was associated with a lower probability of appropriate prophylaxis (p <0.04). Three patients (10%) had a clotting-related outcome. CONCLUSIONS: The 30% rate of VTE prophylaxis in the ESRD group is consistent with the general prophylaxis rate. Lower-risk patients appropriately received no treatment, whereas treatment was omitted in high-risk ESRD patients. The observed rate of 10% thrombosis-related diagnoses may underestimate the actual thrombosis rate.

UR - http://www.scopus.com/inward/record.url?scp=56049091310&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=56049091310&partnerID=8YFLogxK

U2 - 10.1002/dat.20280

DO - 10.1002/dat.20280

M3 - Article

AN - SCOPUS:56049091310

VL - 37

SP - 439

EP - 444

JO - Dialysis and Transplantation

JF - Dialysis and Transplantation

SN - 0090-2934

IS - 11

ER -