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Antithrombotic therapy practices in US hospitals in an era of practice guidelines.

Publication ,  Journal Article
Tapson, VF; Hyers, TM; Waldo, AL; Ballard, DJ; Becker, RC; Caprini, JA; Khetan, R; Wittkowsky, AK; Colgan, KJ; Shillington, AC ...
Published in: Archives of internal medicine
July 2005

Antithrombotic therapy is efficacious for the prevention of thromboembolic disease, but it necessitates careful risk-benefit assessment.Antithrombotic therapy data were retrospectively collected from inpatient medical records at 38 US hospitals. Patients treated for atrial fibrillation, acute myocardial infarction, deep vein thrombosis, or pulmonary embolism and patients given prophylaxis for total knee replacement, total hip replacement, or hip fracture surgery between July 1, 2000, and June 30, 2003, were randomly selected.The medical records of 3778 patients (53.3% men) were included. The mean patient age was 66.1 years. Of patients with atrial fibrillation at high risk for stroke, only 54.7% received warfarin sodium, and 20.6% received neither aspirin nor warfarin. Of patients with acute myocardial infarction, only 75.5% received aspirin on hospital arrival. After orthopedic surgery procedures, only 85.6% of patients received prophylaxis with a parenteral anticoagulant agent or warfarin. In 49.4% of patients with deep vein thrombosis, pulmonary embolism, or both, unfractionated or low-molecular-weight heparin use was discontinued before an international normalized ratio of 2.0 or greater was achieved for 2 consecutive days. Patients with deep vein thrombosis or pulmonary embolism were rarely discharged from the hospital with bridge therapy (an injectable anticoagulant agent plus warfarin), although the length of hospitalization was significantly shorter than if discharged taking warfarin alone (4.0 vs 8.1 days; P < .001).A significant percentage of hospitalized patients do not receive adequate antithrombotic therapy for the primary and secondary prevention of thromboembolic disease.

Duke Scholars

Published In

Archives of internal medicine

DOI

EISSN

1538-3679

ISSN

0003-9926

Publication Date

July 2005

Volume

165

Issue

13

Start / End Page

1458 / 1464

Related Subject Headings

  • Warfarin
  • United States
  • Treatment Outcome
  • Thromboembolism
  • Risk Factors
  • Retrospective Studies
  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Inpatients
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tapson, V. F., Hyers, T. M., Waldo, A. L., Ballard, D. J., Becker, R. C., Caprini, J. A., … NABOR (National Anticoagulation Benchmark and Outcomes Report) Steering Committee, . (2005). Antithrombotic therapy practices in US hospitals in an era of practice guidelines. Archives of Internal Medicine, 165(13), 1458–1464. https://doi.org/10.1001/archinte.165.13.1458
Tapson, Victor F., Thomas M. Hyers, Albert L. Waldo, David J. Ballard, Richard C. Becker, Joseph A. Caprini, Roger Khetan, et al. “Antithrombotic therapy practices in US hospitals in an era of practice guidelines.Archives of Internal Medicine 165, no. 13 (July 2005): 1458–64. https://doi.org/10.1001/archinte.165.13.1458.
Tapson VF, Hyers TM, Waldo AL, Ballard DJ, Becker RC, Caprini JA, et al. Antithrombotic therapy practices in US hospitals in an era of practice guidelines. Archives of internal medicine. 2005 Jul;165(13):1458–64.
Tapson, Victor F., et al. “Antithrombotic therapy practices in US hospitals in an era of practice guidelines.Archives of Internal Medicine, vol. 165, no. 13, July 2005, pp. 1458–64. Epmc, doi:10.1001/archinte.165.13.1458.
Tapson VF, Hyers TM, Waldo AL, Ballard DJ, Becker RC, Caprini JA, Khetan R, Wittkowsky AK, Colgan KJ, Shillington AC, NABOR (National Anticoagulation Benchmark and Outcomes Report) Steering Committee. Antithrombotic therapy practices in US hospitals in an era of practice guidelines. Archives of internal medicine. 2005 Jul;165(13):1458–1464.

Published In

Archives of internal medicine

DOI

EISSN

1538-3679

ISSN

0003-9926

Publication Date

July 2005

Volume

165

Issue

13

Start / End Page

1458 / 1464

Related Subject Headings

  • Warfarin
  • United States
  • Treatment Outcome
  • Thromboembolism
  • Risk Factors
  • Retrospective Studies
  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Inpatients