Primary Thromboprophylaxis in Individuals without Cancer Admitted to a Geriatric Palliative Care Unit

Background/ObjectivesThe prevalence of individuals with advanced noncancer disease is increasing on palliative care units (PCUs), but there are no current guidelines to direct venous thromboembolism (VTE) prophylaxis decisions in these individuals. The aim of this study was to compare primary VTE prophylaxis in elderly adults with advanced noncancer diagnoses with that of those with advanced cancer on a dedicated geriatric PCU. DesignSingle-center retrospective chart review. SettingBaycrest Health Sciences PCU, Toronto, Ontario, Canada. ParticipantsAll 317 individuals admitted to and discharged in 2015 were included in the initial analysis. ResultsThree hundred sixteen individuals were included in the final analysis, 56 (17.7%) of whom had a noncancer diagnosis. VTE prophylaxis was administered in 31.8% of participants with cancer and 26.8% of those without (P=.28). Two hundred eleven (66.6%) participants were admitted from the hospital, and 96 (30.3%) were admitted from home. Participants admitted from the hospital were more likely to receive VTE prophylaxis (39.8% vs 13.7%; P<.05). Mean admission PPS score was 31.4 for participants without cancer and 36.0 for those with cancer (P<.05). Length of stay was shorter for participants with a PPS score less than 30 (18.6 vs 33.6days; P<.05). The rate of VTE prophylaxis in participants who were bedbound was similar to that in those who were ambulatory (29.8% vs 32.2%; P=.36). ConclusionVTE prophylaxis rates were similar in participants with and without cancer on a geriatric PCU. The rate was not significantly less for nonambulatory participants. Further research would help to better guide VTE prophylaxis decisions and minimize suffering at the end of life.