Predictors for the prescription of pharmacological prophylaxis for venous thromboembolism during hospitalization in Internal Medicine: a sub-analysis of the FADOI-NoTEVole study

被引:0
作者
Abenante, Alessia [1 ]
Squizzato, Alessandro [2 ]
Bertu, Lorenza [2 ]
Arioli, Dimitriy [3 ]
Buso, Roberta [4 ]
Carrara, Davide [5 ]
Ciarambino, Tiziana [6 ]
Dentali, Francesco [2 ]
机构
[1] ASST Sette Laghi, Internal Med Dept, Varese, Italy
[2] Univ Insubria, Res Ctr Thromboembol Disorders & Antithrombot Ther, Varese Como, Italy
[3] AUO Modena, Internal Med & Crit Area, Modena, Italy
[4] Univ Hosp Ca Foncello, Internal Med Dept, Treviso, Italy
[5] Hosp Versilia, Internal Med Unit, AUSL Toscana Nord Ovest, Pisa, Italy
[6] Hosp Marciabise, Internal Med Dept, ASL Caserta, Caserta, Italy
关键词
Thromboprophylaxis; Risk assessment models; Hospitalization; Internal medicine; PULMONARY-EMBOLISM; RISK; PREVENTION; GUIDELINES; THROMBOSIS; PLACEBO;
D O I
10.1007/s11739-024-03770-w
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients hospitalized in Internal Medicine Units (IMUs) may frequently experience both an increased risk for thrombosis and bleeding. The use of risk assessment models (RAMs) could aid their management. We present a post-hoc analysis of the FADOI-NoTEVole study, an observational, retrospective, multi-center study conducted in 38 Italian IMUs. The primary aim of the study was to evaluate the predictors associated with the prescription of thromboprophylaxis during hospitalization. The secondary objective was to evaluate RAMs adherence. Univariate analyses were conducted as preliminary evaluations of the variables associated with prescribing pharmacological thromboprophylaxis during hospital stay. The final multivariable logistic model was obtained by a stepwise selection method, using 0.05 as the significance level for entering an effect into the model. Thromboprophylaxis was then correlated with the RAMs and the number of predictors found in the multivariate analysis. Thromboprophylaxis was prescribed to 927 out of 1387 (66.8%) patients with a Padua Prediction score (PPS) >= 4. Remarkably, 397 in 1230 (32.3%) patients with both PPS >= 4 and an IMPROVE bleeding risk score (IBS) < 7 did not receive it. The prescription of thromboprophylaxis mostly correlated with reduced mobility (OR 2.31; 95% CI 1.90-2.81), ischemic stroke (OR 2.38; 95% CI 1.34-2.91), history of previous thrombosis (OR 2.46; 95% CI 1.49-4.07), and the presence of a central venous catheter (OR 3.00; 95% CI 1.99-4.54). The bleeding risk assessment using the IBS did not appear to impact physicians' decisions. Our analysis provides insight into how indications for thromboprophylaxis were determined, highlighting the difficulties faced by physicians with patients admitted to IMUs.
引用
收藏
页码:151 / 158
页数:8
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