Venous thromboembolism risk stratification in medically-ill hospitalized cancer patients. A comprehensive cancer center experience

Venous thromboembolism risk stratification in medically-ill hospitalized cancer patients. A comprehensive cancer center experience

Cancer and its treatment are recognized risk factors for VTE. Compliance rate with published VTE prophylaxis guidelines is low. Decision on when to offer prophylaxis for hospitalized cancer patients is difficult to make. This paper describes current clinical practice in offering VTE prophylaxis to h...

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Bibliographic Details
Published in:Journal of thrombosis and thrombolysis Vol. 30; no. 3; pp. 286 - 293
Main Authors: Abdel-Razeq, H. N., Hijjawi, S. B., Jallad, S. G., Ababneh, B. A.
Format: Journal Article
Language:English
Published: Boston Springer US 01-10-2010
Springer Nature B.V
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Cardiology
Female
Hematology
Hospitalization
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasms - complications
Neoplasms - therapy
Practice Guidelines as Topic
Premedication - methods
Premedication - statistics & numerical data
Prospective Studies
Risk Assessment
Risk Factors
Venous Thromboembolism - etiology
Venous Thromboembolism - prevention & control
Young Adult
Low molecular weight heparin
Thromboembolism
Risk stratification
Cancer
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Summary:Cancer and its treatment are recognized risk factors for VTE. Compliance rate with published VTE prophylaxis guidelines is low. Decision on when to offer prophylaxis for hospitalized cancer patients is difficult to make. This paper describes current clinical practice in offering VTE prophylaxis to hospitalized cancer patients. Prophylaxis rate and rate of VTE will be correlated with the risk level. We prospectively followed all consecutive adult cancer patients admitted to medical units over a 5-month period. Caprini risk assessment model, with some modifications, was utilized to determine risk of VTE. Six hundred and six patients (51% males, median age 52 years, range 18–91) were included. Reasons for admission included infections (25%), chemotherapy (22%) and palliative care (10%). In addition to cancer, the most frequently encountered risk factors for VTE were: Immobilization (35%), age > 60 years (31%) and body mass index > 30 in (20%). Patients were grouped according to their total risk score: low (9%), moderate (44%) and high risk (47%). VTE prophylaxis rate was 55.1% for the whole study group. Following discharge, patients were followed for 60 days. The incidence of VTE was 3.4% in the moderate and 4.2% in the high risk groups, while none in the low risk group developed VTE. Many additional risk factors for VTE are usually encountered in hospitalized cancer patients. Cancer alone may not be an enough reason for VTE prophylaxis. Risk assessment model able to stratify patients into different risk categories will simplify decision making and enhance VTE prophylaxis rate.
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ISSN:0929-5305
1573-742X
DOI:10.1007/s11239-010-0445-9