Venous Thromboembolism Prophylaxis in Pediatric Inflammatory Bowel Disease Patients Hospitalized With a Central Line

被引：2

作者：

Hamant, Laura G. ^{[1
]}

Gonzalez-llanos, Lucia ^{[1
]}

Patel, Ashish S. ^{[1
,2
]}

McMahon, Lisa ^{[1
,3
]}

Knoll, Christine ^{[1
,4
]}

Swing, Ted ^{[1
]}

Pasternak, Brad ^{[1
,2
,5
]}

机构：

[1] Phoenix Childrens Hosp, Phoenix, AZ USA

[2] Phoenix Childrens Hosp, Dept Gastroenterol, Phoenix, AZ USA

[3] Phoenix Childrens Hosp, Dept Surg, Phoenix, AZ USA

[4] Phoenix Childrens Hosp, Dept Hematol Oncol, Phoenix, AZ USA

[5] Div Gastroenterol, 1919 E Thomas Rd, Phoenix, AZ 85016 USA

来源：

JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION | 2023年 / 76卷 / 05期

关键词：

Crohn disease; deep vein thrombosis; enoxaparin; ulcerative colitis; RISK; THROMBOPROPHYLAXIS; PREVENTION; THROMBOSIS; CHILDREN;

D O I：

10.1097/MPG.0000000000003747

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives:Patients hospitalized with inflammatory bowel disease (IBD) have increased risk of venous thromboembolism (VTE). The aim of this study was to determine whether the adoption of a VTE protocol would change rates of medical VTE prophylaxis (low molecular weight heparin) in patients with IBD and a central venous catheter (CVC), while subsequently decreasing the incidence of VTE in this population. Methods:A protocol for VTE prophylaxis in IBD was established in March of 2018. Every patient hospitalized with an IBD flare and central venous access from March 2013 to March 2020 was identified. Study data, including patient demographics, rates of Doppler ultrasound (US), and rates of VTE were collected using International Classification of Diseases (ICD)-10 codes, CPT codes, and chart review retrospectively. Determination of an IBD flare was based on physician global assessment. Groups were compared with independent-sample t tests and chi-squared tests. Results:A total of 313 hospitalizations across 187 different patients were identified that met criteria including IBD and central venous access. VTE prophylaxis increased from 5.24% (n = 12) prior to the intervention to 63.10% (n = 53) after the intervention [chi-square (1, N = 313) = 125.0192, P < 0.001]. Rate of Doppler US increased from 9.17% (n = 21) prior to the intervention to 17.86% (n = 15) after the intervention [chi-square (1, N = 313) = 4.5562, P < 0.05]. Diagnosis of VTE increased from 0.87% (n = 2) prior to the intervention to 7.14% (n = 6) after the intervention [chi-square (1, N = 313) = 9.6992, P < 0.01]. There were no significant differences in the demographic characteristics pre- versus post-intervention. Conclusions:Rates of Doppler US and VTE prophylaxis use increased significantly after implementation of a VTE protocol. Rates of VTE diagnosis also increased, though we suspect this may be due to missed diagnoses prior to implementation of the protocol and increased risk awareness after the protocol was established.

引用

页码：610 / 615

页数：6

共 24 条

[1] The Incidence and Characteristics of Venous Thromboembolisms in Paediatric-Onset Inflammatory Bowel Disease: A Prospective International Cohort Study Based on the PIBD-SETQuality Safety Registry [J].