Background: Venous thromboembolism (VTE) is a significant cause of morbidity and mortality for hospitalized patients, and VTE are considered preventable events with appropriate prophylaxis. However, prophylaxis is frequently delayed on hospital admission. We investigated the incidence of VTE prophylaxis delays for high-risk patients admitted to our institution.
Aims: To reduce VTE prophylaxis delays by 75% in the next year for all high-risk patients admitted to the medical floor.
Methods: We performed a retrospective chart review of 100 medically ill patients admitted to our institution from the Emergency Department from December 2018 to March 2019. Data collection consisted of patient demographics, length of stay, timing of prophylaxis for VTE, type of VTE prophylaxis, and Padua Prediction Score.
Results: The first dose of prophylaxis was given within 24 hours of arrival to 75% of patients, with only 25% of patients receiving their first dose within 8 hours. Of all 100 patients, 13 patients did not receive prophylaxis at all. The length of time between prophylaxis order and first dose administration showed that 74% of patients received prophylaxis within 12 hours; only 36% of patients received prophylaxis in under 4 hours from the time the order was placed. In addition, 62% of patients had a Padua score ≥ 4 at the time of admission, suggesting significant risk for VTE.
Conclusions: Our investigation revealed a disparity in length between admission time and first dose of prophylaxis. The study also showed a 2% mortality rate, with 3% of all patients developing a VTE. These results would require further study to demonstrate a relationship between delays in VTE prophylaxis and adverse outcomes in the medically ill population. We recommend implementation of a standard STAT order for patients at high risk for VTE according to the Padua Prediction score to receive prophylaxis by the admitting team and then a routine order to follow.
To cite this abstract in AMA style:Patel K, Lombardo H, Fulton R, Knapp J, Knox T, Lóser M, Hallam A, Macchiavelli A. Delays of VTE Prophylaxis [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/delays-of-vte-prophylaxis/. Accessed September 23, 2021.
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